Changes in Quality of Life after 3 months of Usual Care in a Large Sample of Patients with Noncancer Pain: The “QOOL: Quality of Life and Pain” Study

Abstract

Large-scale observational studies can provide useful information on changes in health outcomes over time. The aim of this study was to investigate the effect of 3 months of usual care on quality of life (QOL) and pain outcomes in noncancer chronic pain patients managed by pain specialists and to examine factors associated with changes in QOL. This was assessed using the EQ-5D and pain outcomes using the Brief Pain Inventory (BPI). Changes in QOL and pain were studied for the overall sample and in subgroups defined by baseline pain severity. Multivariate regression was used to investigate factors associated with change on EQ-5D. Three thousand and twenty-nine patients were included for analysis. After 3 months of usual care, a mean of 40.9% of patients showed improvement on individual EQ-5D dimensions, with the highest rates of improvement seen on the pain/discomfort (50.8%) and anxiety/depression (48.3%) dimensions. The EQ-5D Index increased from a mean (SD) of 0.35 (0.2) to 0.58 (0.21) points between baseline and month 3, and the thermometer from 41.5 (19.4) to 58.7 (17.8), indicating a large effect. Improvements in QOL were larger in those with severe baseline pain. The BPI severity summary score improved from a mean (SD) of 6.5 (1.4) to 4.1 (1.7) and the interference summary score from 6.6 (1.5) to 4.2 (1.9). Changes on the BPI severity and interference scores were associated with changes in the EQ-5D Index and thermometer. In conclusion, 3 months of usual care in noncancer pain patients led to substantial improvements in QOL and pain outcomes.

An exploratory, large-scale study of pain and quality of life outcomes in cancer patients with moderate or severe pain, and variables predicting improvement

“…In terms of the factors associated with change in QoL in all types of cancer, the most relevant were baseline performance status, change on the BPI severity and interference sub-scales, EQ-5D Index score at baseline, and presence of anxiety/depression at both visits. An earlier study demonstrated the relationship between improvements in pain as measured by the BPI and improvements in QoL [ 22 ], though that was not performed in cancer patients. The effect of changes in pain on QoL scores is strong, with the regression analysis suggesting that an approximately two point change on either the BPI pain severity or pain interference sub-scales would lead to a change on the EQ-Index which would be close to its minimal important difference (MID), i.e.…”

Libro Blanco del Dolor Crónico en España

“…En todas las dimensiones del EQ-5D se observó una reducción considerable en la proporción de pacientes que reportaban problemas moderados a severos, especialmente, en las dimensiones depresión/ansiedad, dolor/malestar y actividades habituales. Adicionalmente, se encontraron mejoras significativas en la severidad e interferencia del dolor media de la muestra, siendo mayores en aquellos pacientes con un dolor basal más severo (Velázquez Rivera et al, 2015).…”

Pain Rating in Women with Provoked Vestibulodynia: Evaluating Influence of Race

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