Defining chronic pain in epidemiological studies: a systematic review and meta-analysis

Abstract

The objective was to document the operational definitions applied in epidemiological studies of chronic pain and to examine whether pain definitions and other methodological factors are systematically related to prevalence estimates. MEDLINE, EMBASE, and PsychINFO were searched for original research reports with study samples of at least 1000 individuals, excluding studies of less than 5 out of 15 selected body regions and studies solely concerned with specific pain conditions. Meta-analyses and meta-regressions were applied with random effects models; covariates were geography, sampling year, survey method, sampling frame, participation rate, percentage women of all participants, pain duration, and pain location. Of 6791 hits, 86 studies were included in the syntheses. The phrasing, content, and combinations of the chronic pain definition criteria were highly inconsistent, with virtually no 2 studies from independent research groups using the exact same criteria. Prevalence estimates ranged from 8.7% to 64.4%, with a pooled mean of 31%. Huge heterogeneity was shown in all forest plots. Prevalence estimates were significantly related to survey method (β = -10.8 [95% confidence interval: -17.2 to -4.4]), but it only counted for a small fraction of the between-studies variation in the estimates. There were also interaction effect of survey method by sex (female-male prevalence ratio [95% confidence interval]: questionnaire = 1.20 [1.16 to 1.25], and interview = 1.38 [1.29 to 1.47]). The other covariates investigated were not significantly related to the prevalence estimates. Researchers and clinicians should be aware of the probability that interview survey method of collecting data may give lower chronic pain reporting than questionnaire survey method and that this effect may be stronger in men than women.

Chronic pain among public safety personnel in Canada

“…The large, diverse Canadian PSP sample is an important strength of the current study, as is the use of items based on established research [31][32][33][34][35][36] ; however, there are several limitations that provide important directions for future research. First, participants were anonymous and selfselected, which means that despite proportional demographic representativeness, the results may not be generalizable.…”

“…Current chronic pain experiences were assessed with items based on work done by the International Association for the Study of Pain 31 and previous reviews [32][33][34][35][36] ; specifically, we asked participants: "Do you experience chronic pain defined by pain more days than not, lasting longer than 3 months?" Response options included "Yes" (n = 1859), "Yes, but I'd rather not discuss it" (n = 176), "No" (n = 3030), and "Prefer not to answer" (n = 28).…”

Palliativmedizin: Grundlagen und Symptommanagement

“…Schmerz ist ein unangenehmes Sinnes-oder Gefühlserlebnis, das mit tatsächlicher oder potenzieller Gewebeschädigung einhergeht oder von betroffenen Personen so beschrieben wird, als wäre eine solche Gewebeschädigung die Ursache [5].…”

Pain Management in the Context of a Nursing Help Line: Identification of Needs, Development of a Continuing Education Activity, and Evaluation of its Impact

“…Persistent pain may also cause various changes in physiology leading to pain sensitization and a condition of chronic pain (Feizerfan & Sheh, 2015). In Canada, the prevalence of chronic pain among adults age 18 and over is about 19% (Schopflocher, Taenzer, & Jovey, 2011;Steingrimsdottir, Landmark, Macfarlane, & Nielsen, 2017). One of the reasons for this high prevalence is that pain is not managed properly.…”