Incidence and impact of pain conditions and comorbid illnesses

Abstract

BackgroundIndividuals with pain often present with more than one painful condition. The purpose of this study was to characterize the rates of comorbidity, pain medication use, and health care costs for 23 selected pain conditions in a large health plan using administrative claims data from 2005 to 2007.MethodsEligible patients included 1,211,483 adults with at least one pain condition during the one-year study period. Pain condition cohorts were classified based on the first diagnosis present in the claims during the study period.ResultsMusculoskeletal pain conditions were among the most prevalent cohorts including low back pain, osteoarthritis, and fibromyalgia. Cancer pain was the least prevalent cohort. Conditions with the lowest illness severity included migraine and painful bladder syndrome cohorts, while cohorts with diabetic neuropathy, human immunodeficiency virus (HIV)-associated pain, and cancer pain were the most severe. Across cohorts, the mean number of comorbid pain conditions ranged from 1.39 (for cancer pain and migraine) to 2.65 (for multiple sclerosis pain). High rates of mental health conditions were found in cohorts with HIV-associated pain and multiple sclerosis pain (42.59% and 34.78%) and were lowest among cohorts with rheumatoid arthritis and psoriatic arthropathy (12.73% and 13.31%), respectively. Rates of sleep disorders ranged from 5.47% (for painful bladder syndrome) to 11.59% (for multiple sclerosis pain). Overall, patients averaged 3.53 unique pain medications during the study period. Considerable annual total health care costs were observed in the cancer pain cohort and the lowest costs were observed in the postherpetic neuropathy, surgically-induced pain, migraine, and irritable bowel syndrome cohorts. Costs attributed to pain were highest among the multiple sclerosis, HIV, and cancer pain cohorts. The highest pharmaceutical costs were observed in the HIV cohort.ConclusionThese findings underscore the heterogeneity of patients with pain in terms of burden of illness, costs to the health care system, and the complexity of commonly co-occurring disorders.

Prevalence and correlates of painful conditions and multimorbidity in national sample of overweight/obese Veterans

“…This is consistent with recent Veteran data demonstrating that those with persistent pain were more likely to report comorbid conditions, including diagnoses of mood disorders, PTSD, substance use disorders, anxiety disorders, and traumatic brain injury; they were also more likely to have a BMI consistent with overweight/obesity [33]. Other research has shown that those with multiple painful conditions have a number of additional medical and mental health comorbidities, along with higher burden of illness and cost of care [34]. Properly addressing chronic pain in medically complex patients may improve health status, functioning, and quality of life, in addition to improving other health conditions [28].…”

Chronic Pain in Multiple Sclerosis Patients: Utility of Sensory Quantitative Testing in Patients with Fibromyalgia Comorbidity

“…In our MS series a 17% of the patients enrolled was diagnosed with FM according to the 1990 ACR criteria. Such comorbidity was previously reported with a significantly lower prevalence in the literature, but those studies were based on administrative claim records [24] and self-reported validated questionnaire [25]. Those tools may be less accurate for uncommon disorders, such as arthritis and FM [9], while in our study a ward rheumatologist performed an examination to assess the presence of comorbid FM, and the differences in the diagnostic methods adopted could explain the high frequency of FM detected in our MS sample.…”

Knowledge and attitude towards pain management. A comparison between oncology and non-oncology nurses in Jordan

“…It is subjective symptoms that affect many hospitalized patients and considered an integral part of human experience [1]. Pain may have debilitating effects on patient's physical, emotional and spiritual wellbeing and thus, can alter their quality of life.…”

“…Pain may have debilitating effects on patient's physical, emotional and spiritual wellbeing and thus, can alter their quality of life. Recently, it is being measured as one of the vital signs [1,2]. Many nurses gain their perceptions toward pain from their knowledge [3].…”