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Short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression

BACKGROUND: Chronic pain and depression are frequent comorbidities in primary care. Depression among other psychosocial factors play a role in the clinical course of chronic pain. OBJECTIVE: To study the short and long-term predictive factors of severity and interference of chronic pain in primary c...

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Autores principales: Rambla, Concepció, Aragonès, Enric, Pallejà-Millán, Meritxell, Tomé-Pires, Catarina, López-Cortacans, Germán, Sánchez-Rodríguez, Elisabet, Miró, Jordi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10074832/
https://www.ncbi.nlm.nih.gov/pubmed/37020278
http://dx.doi.org/10.1186/s12891-023-06357-2
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author Rambla, Concepció
Aragonès, Enric
Pallejà-Millán, Meritxell
Tomé-Pires, Catarina
López-Cortacans, Germán
Sánchez-Rodríguez, Elisabet
Miró, Jordi
author_facet Rambla, Concepció
Aragonès, Enric
Pallejà-Millán, Meritxell
Tomé-Pires, Catarina
López-Cortacans, Germán
Sánchez-Rodríguez, Elisabet
Miró, Jordi
author_sort Rambla, Concepció
collection PubMed
description BACKGROUND: Chronic pain and depression are frequent comorbidities in primary care. Depression among other psychosocial factors play a role in the clinical course of chronic pain. OBJECTIVE: To study the short and long-term predictive factors of severity and interference of chronic pain in primary care patients with chronic musculoskeletal pain and major depression. METHODS: Longitudinal study of a cohort of 317 patients. The outcomes are severity and functional interference of pain (Brief Pain Inventory) measured at 3 and 12 months. We performed multivariate linear regression models to estimate the effects the explanatory baseline variables on the outcomes. RESULTS: 83% participants were women; average age was 60.3 years (SD = 10.2). In multivariate models, baseline pain severity predicted pain severity at 3 months (β = 0.53; 95% CI = 0.37–0.68) and at 12 months (β = 0.48; 95% CI = 0.29–0.67). Also, pain > 2 years of evolution predicted long term pain severity (β = 0.91; CI95%=0.11–1.71). Baseline pain interference predicted interference at 3 and 12 months (β = 0.27; 95%CI = 0.11–0.43 and β = 0.21; 95%CI = 0.03–0.40, respectively). Baseline pain severity predicted interference at 3 and 12 months (β = 0.26; 95%CI = 0.10–0.42 and β = 0.20; 95%CI = 0.02–0.39, respectively). Pain > 2 years predicted greater severity and greater interference at 12 months (β = 0.91; CI95%=0.11–1.71, and β = 1.23; CI95%=0.41–2.04). Depression severity predicted more interference at 12 months (β = 0.58; CI95%=0.04–1.11). Occupational status as active worker predicted less interference throughout the follow-up (β=-0.74; CI95%=-1.36 to -0.13 and β=-0.96; CI95%=-1.71 to -0.21, at 3 and 12 months). Currently working also predicts less pain severity at 12 months (β=-0.77; CI95%=1.52 − 0.02). With regard to the psychological variables, pain catastrophizing predicted pain severity and interference at three months (β = 0.03; 95% CI = 0.00-0.05 and β = 0.03; 95% CI = 0.00-0.05), but not at long term. CONCLUSION: In a sample of adults with chronic pain and depression, this primary care study has identified prognostic factors that independently predict the severity and functional interference of pain. If confirmed in new studies, these factors should be targeted for individualized interventions. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02605278), registered 16/11/2015. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-023-06357-2.
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spelling pubmed-100748322023-04-06 Short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression Rambla, Concepció Aragonès, Enric Pallejà-Millán, Meritxell Tomé-Pires, Catarina López-Cortacans, Germán Sánchez-Rodríguez, Elisabet Miró, Jordi BMC Musculoskelet Disord Research BACKGROUND: Chronic pain and depression are frequent comorbidities in primary care. Depression among other psychosocial factors play a role in the clinical course of chronic pain. OBJECTIVE: To study the short and long-term predictive factors of severity and interference of chronic pain in primary care patients with chronic musculoskeletal pain and major depression. METHODS: Longitudinal study of a cohort of 317 patients. The outcomes are severity and functional interference of pain (Brief Pain Inventory) measured at 3 and 12 months. We performed multivariate linear regression models to estimate the effects the explanatory baseline variables on the outcomes. RESULTS: 83% participants were women; average age was 60.3 years (SD = 10.2). In multivariate models, baseline pain severity predicted pain severity at 3 months (β = 0.53; 95% CI = 0.37–0.68) and at 12 months (β = 0.48; 95% CI = 0.29–0.67). Also, pain > 2 years of evolution predicted long term pain severity (β = 0.91; CI95%=0.11–1.71). Baseline pain interference predicted interference at 3 and 12 months (β = 0.27; 95%CI = 0.11–0.43 and β = 0.21; 95%CI = 0.03–0.40, respectively). Baseline pain severity predicted interference at 3 and 12 months (β = 0.26; 95%CI = 0.10–0.42 and β = 0.20; 95%CI = 0.02–0.39, respectively). Pain > 2 years predicted greater severity and greater interference at 12 months (β = 0.91; CI95%=0.11–1.71, and β = 1.23; CI95%=0.41–2.04). Depression severity predicted more interference at 12 months (β = 0.58; CI95%=0.04–1.11). Occupational status as active worker predicted less interference throughout the follow-up (β=-0.74; CI95%=-1.36 to -0.13 and β=-0.96; CI95%=-1.71 to -0.21, at 3 and 12 months). Currently working also predicts less pain severity at 12 months (β=-0.77; CI95%=1.52 − 0.02). With regard to the psychological variables, pain catastrophizing predicted pain severity and interference at three months (β = 0.03; 95% CI = 0.00-0.05 and β = 0.03; 95% CI = 0.00-0.05), but not at long term. CONCLUSION: In a sample of adults with chronic pain and depression, this primary care study has identified prognostic factors that independently predict the severity and functional interference of pain. If confirmed in new studies, these factors should be targeted for individualized interventions. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02605278), registered 16/11/2015. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-023-06357-2. BioMed Central 2023-04-05 /pmc/articles/PMC10074832/ /pubmed/37020278 http://dx.doi.org/10.1186/s12891-023-06357-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Rambla, Concepció
Aragonès, Enric
Pallejà-Millán, Meritxell
Tomé-Pires, Catarina
López-Cortacans, Germán
Sánchez-Rodríguez, Elisabet
Miró, Jordi
Short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression
title Short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression
title_full Short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression
title_fullStr Short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression
title_full_unstemmed Short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression
title_short Short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression
title_sort short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10074832/
https://www.ncbi.nlm.nih.gov/pubmed/37020278
http://dx.doi.org/10.1186/s12891-023-06357-2
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