A Review of Potential National Chronic Pain Surveillance Systems in the United States

Duca, Lindsey M.; Helmick, Charles G.; Barbour, Kamil E.; Nahin, Richard L.; Korff, Michael Von; Theis, Kristina A.; Guglielmo, Dana; Porter, Linda; Falasinnu, Titilola; Mackey, Sean

doi:10.1016/j.jpain.2022.02.013

Cited by 21 publications

(11 citation statements)

References 43 publications

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“…This approach may be limited by recall bias or by basing inclusion on 4 weeks of pain. 43 Findings indicate (1) similar trends for acupuncture, chiropractic, massage, and OT/PT; (2) a larger prevalence of neither treatment (eFigure 2 and eFigure 3 in the Supplement ); and (3) a less notable decrease in the odds of using neither treatment (eTable 8 in the Supplement ).…”

Section: Resultsmentioning

confidence: 87%

Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019

et al. 2022

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ImportanceChronic pain prevalence among US adults increased between 2010 and 2019. Yet little is known about trends in the use of prescription opioids and nonpharmacologic alternatives in treating pain.ObjectivesTo compare annual trends in the use of prescription opioids, nonpharmacologic alternatives, both treatments, and neither treatment; compare estimates for the annual use of acupuncture, chiropractic care, massage therapy, occupational therapy, and physical therapy; and estimate the association between calendar year and pain treatment based on the severity of pain interference.Design, Setting, and ParticipantsA serial cross-sectional analysis was conducted using the nationally representative Medical Expenditure Panel Survey to estimate the use of outpatient services by cancer-free adults with chronic or surgical pain between calendar years 2011 and 2019. Data analysis was performed from December 29, 2021, to August 5, 2022.ExposuresCalendar year (2011-2019) was the primary exposure.Main Outcomes and MeasuresThe association between calendar year and mutually exclusive pain treatments (opioid vs nonpharmacologic vs both vs neither treatment) was examined. A secondary outcome was the prevalence of nonpharmacologic treatments (acupuncture, chiropractic care, massage therapy, occupational therapy, and physical therapy). All analyses were stratified by pain type.ResultsAmong the unweighted 46 420 respondents, 9643 (20.4% weighted) received surgery and 36 777 (79.6% weighted) did not. Weighted percentages indicated that 41.7% of the respondents were aged 45 to 64 years and 55.0% were women. There were significant trends in the use of pain treatments after adjusting for demographic factors, socioeconomic status, health conditions, and pain severity. For example, exclusive use of nonpharmacologic treatments increased in 2019 for both cohorts (chronic pain: adjusted odds ratio [aOR], 2.72; 95% CI, 2.30-3.21; surgical pain: aOR, 1.53; 95% CI, 1.13-2.08) compared with 2011. The use of neither treatment decreased in 2019 for both cohorts (chronic pain: aOR, 0.43; 95% CI, 0.37-0.49; surgical pain: aOR, 0.59; 95% CI, 0.46-0.75) compared with 2011. Among nonpharmacologic treatments, chiropractors and physical therapists were the most common licensed healthcare professionals.Conclusions and RelevanceAmong cancer-free adults with pain, the annual prevalence of nonpharmacologic pain treatments increased and the prevalent use of neither opioids nor nonpharmacologic therapy decreased for both chronic and surgical pain cohorts. These findings suggest that, although access to outpatient nonpharmacologic treatments is increasing, more severe pain interference may inhibit this access.

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Section: Resultsmentioning

confidence: 87%

Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019

et al. 2022

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“…12,19,37 While these findings have been primarily based on cross-sectional samples, longitudinal research on employment outcomes of chronic pain has remained limited. 9,18 Previous longitudinal studies on chronic pain and employment have been focused on employment outcomes of pain treatment including care coordination, pharmacotherapy, and workplace modification. 6,9,23,25,36 Specific interventions such as physical activity and exercise therapy were shown to accelerate return to work by 5 weeks in one study, whereas early medical management by a physiatrist resulted in a 38% improvement in return to work after an occupational injury.…”

Section: Discussionmentioning

confidence: 99%

“…9,18 Previous longitudinal studies on chronic pain and employment have been focused on employment outcomes of pain treatment including care coordination, pharmacotherapy, and workplace modification. 6,9,23,25,36 Specific interventions such as physical activity and exercise therapy were shown to accelerate return to work by 5 weeks in one study, whereas early medical management by a physiatrist resulted in a 38% improvement in return to work after an occupational injury. 15,20 Although these studies have connected the treatment of chronic pain to improved employment outcomes over time, they did not identify how chronic pain contributed to the initial exit from the labor force.…”

Section: Discussionmentioning

confidence: 99%

Pain interference in young adulthood and work participation

Pooleri

Yeduri

Horne

et al. 2022

Pain

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Chronic pain is associated with reduced work participation, but longitudinal data on the work impact of chronic pain are limited. We used data from the National Longitudinal Survey of Youth-1997 cohort to analyze how pain interference in early adulthood was associated with subsequent exit from the labor force in a longitudinal survey. Pain interference at age 29 and employment status were self-reported at subsequent biennial interviews. Exit from the labor force, return to employment, and development of new health-related work limitations after age 29 were analyzed using survival analysis methods. Among 5819 respondents, 10% and 3% endorsed "a little" or "a lot" of pain interference at age 29, respectively. During follow-up (median of 26 months until censoring or labor force exit), 43% of respondents had exited the labor force at least once and 10% developed a new work-related health limitation. The highest pain interference group (compared with no pain interference) had higher hazard of labor force exit (hazard ratio: 1.26; 95% confidence interval: 1.01-1.57; P 5 0.044) and of developing new health-related work limitations (hazard ratio: 2.45; 95% confidence interval: 1.64-3.67; P , 0.001), with similar results for the group experiencing "a little" pain interference at age 29. In this nationally representative cohort, any level of pain interference reported at age 29 was found to predict increased hazards of subsequent labor force exit and health-related work limitation. Early identification and treatment of pain problems among young workers can help reduce burdens of future unemployment and disability.

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“…While the NHIS provided data regarding pain interference (2016-2017), pain intensity, chronicity of pain, and pain management (2015-2018), we did not include these variables in our analysis because they were not available for our entire study period. 19…”

Section: Methodsmentioning

confidence: 99%

Seventeen-Year National Pain Prevalence Trends Among U.S. Military Veterans

Taylor

Kapos

Sharpe

et al. 2023

Preprint

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Importance:U.S. military veterans experience higher pain prevalence and severity than nonveterans. However, it is unclear how these differences have changed over time. Previous studies are limited to veterans receiving care from the Veterans Health Administration.Objective:To characterize pain prevalence trends in the overall population of U.S. veterans compared to nonveterans, using nationally-representative data.Design:Repeated cross-sectional study. Data: National Health Interview Survey, 2002-2018. Analysis: January 2023.Setting:Population-based survey of noninstitutionalized U.S. adults.Participants:Across the 17-year period, mean annual weighted population was 229.7 million adults (unweighted sample total: n=506,639; unweighted sample annual mean: n=29,802).Exposure:Veteran status.Main Outcomes:Crude and demographics-adjusted pain prevalence trend differences between veterans and nonveterans across five pain variables (severe headache or migraine, facial pain, neck pain, low back pain, and joint pain) and two composite variables (any pain [≥1 prevalent pain] and multiple pains [≥2 prevalent pains]).Results:Weighted proportion of veterans varied from 11.48% in 2002 (highest) to 8.41% in 2017 (lowest). Across the study period, crude prevalence was generally similar or higher among veterans than nonveterans for all pain variables except for severe headache or migraine and facial pain. When equalizing age, sex, race, and ethnicity, pain prevalence among veterans remained similar or higher than nonveterans for all pain variables. From 2002 to 2018 there was an absolute increase (95% CI) in pain prevalence among veterans (severe headache or migraine: 2.0% [1.6% to 2.4%]; facial pain: 1.9% [1.4% to 2.4%]; neck pain: 4.7% [4.1% to 5.2%]; joint pain: 11.4% [10.8% to 11.9%]; low back pain: 10.3% [9.5% to 11.1%]; any pain: 10.0% [9.6% to 10.4%]; and multiple pains: 9.9% [9.2% to 10.6%]. Crude and adjusted analyses indicated prevalence of all pain variables increased more among veterans than nonveterans from 2002 to 2017.Conclusion and Relevance:Veterans had similar or higher adjusted prevalence and higher rates of increase over time for all pain variables compared to nonveterans. Continued pain prevalence increase among veterans may impact healthcare utilization (within and outside of the VHA), underscoring the need for improved pain prevention and care programs for these individuals with disproportionate pain burden.

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A Review of Potential National Chronic Pain Surveillance Systems in the United States

Cited by 21 publications

References 43 publications

Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019

Trends in the Use of Opioids vs Nonpharmacologic Treatments in Adults With Pain, 2011-2019

Pain interference in young adulthood and work participation

Seventeen-Year National Pain Prevalence Trends Among U.S. Military Veterans

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