Pain severity reduces life quality in chronic pancreatitis: Implications for design of future outcome trials

Olesen, Søren Schou; Juel, Jacob; Nielsen, Anders Klitgaard; Frøkjær, Jens Brøndum; Wilder–Smith, Oliver H.G.; Drewes, Asbjørn Mohr

doi:10.1016/j.pan.2014.09.009

Cited by 89 publications

(64 citation statements)

References 25 publications

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“…(9) While the association of pain with poor QOL is consistent across studies(3, 5–10), whether the effect is greater with severity or temporal nature of pain is debatable. A small single center Polish study of 69 patients revealed that pain intensity correlates with QOL scores more often than frequency.…”

Section: Discussionmentioning

confidence: 95%

“…(8) More recently, Olesen et al assessed the association between the intensity and temporal pattern of pain with the QOL of 106 CP patients from two tertiary medical centers in Netherlands and Denmark. (10) In addition to measuring pain severity by the modified brief pain inventory short form (m-BPI-sf),(21) the authors used this scale to indirectly classify pain frequency into 3 patterns: intermittent, constant, and constant with acute exacerbations. After adjustment for confounders, they found that pain severity but not pain pattern was significantly correlated with global health status, all functional subscales, and most symptom subscales.…”

Section: Discussionmentioning

confidence: 99%

“…(3, 5–10) Treatment of pain by surgical or endoscopic therapy has documented effect not only in achieving pain relief but also in improving QOL. (11–14) Etiology of CP has not been found to affect QOL.…”

Section: Introductionmentioning

confidence: 99%

“…(3, 5, 8) Younger age, female sex, smoking, alcohol consumption, low body mass index, diabetes, exocrine pancreatic insufficiency, pancreatic morphology, and disease duration lower QOL, but their association has been inconsistent across studies. (3, 5, 7, 8, 10) The reasons for this inconsistency include variability in the instruments used to determine QOL, small sample size of studies and the lack of use of uniform predictor variables. The effect of pain-related disability or unemployment on QOL has not been adequately studied.…”

Section: Introductionmentioning

confidence: 99%

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Quality of Life in Chronic Pancreatitis is Determined by Constant Pain, Disability/Unemployment, Current Smoking, and Associated Co-Morbidities

Machicado

Amann

Anderson

et al. 2017

American Journal of Gastroenterology

159

135

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Background Chronic pancreatitis (CP) has a profound independent effect on quality of life (QOL). Our aim was to identify factors that impact the QOL in CP patients. Methods We used data on 1,024 CP patients enrolled in the three NAPS2 studies. Information on demographics, risk factors, co-morbidities, disease phenotype and treatments was obtained from responses to structured questionnaires. Physical (PCS) and mental (MCS) component summary scores generated using responses to the Short Form-12 (SF-12) survey were used to assess QOL at enrollment. Multivariable linear regression models determined independent predictors of QOL. Results Mean PCS and MCS scores were 36.7±11.7 and 42.4±12.2, respectively. Significant (p<0.05) negative impact on PCS scores in multivariable analyses was noted due to constant mild-moderate pain with episodes of severe pain or constant severe pain (10 points), constant mild-moderate pain (5.2), pain-related disability/unemployment (5.1), current smoking (2.9 points) and medical co-morbidities. Significant (p<0.05) negative impact on MCS scores was related to constant pain irrespective of severity (6.8-6.9 points), current smoking (3.9 points) and pain-related disability/unemployment (2.4 points). In women, disability/unemployment resulted in an additional reduction 3.7 point reduction in MCS score. Final multivariable models explained 27% and 18% of the variance in PCS and MCS scores, respectively. Etiology, disease duration, pancreatic morphology, diabetes, exocrine insufficiency and prior endotherapy/pancreatic surgery had no significant independent effect on QOL. Conclusion Constant pain, pain-related disability/unemployment, current smoking, and concurrent co-morbidities significantly affect the QOL in CP. Further research is needed to identify factors impacting QOL not explained by our analyses.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Quality of Life in Chronic Pancreatitis is Determined by Constant Pain, Disability/Unemployment, Current Smoking, and Associated Co-Morbidities

Machicado

Amann

Anderson

et al. 2017

American Journal of Gastroenterology

159

135

View full text Add to dashboard Cite

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“…Pain severity reduces quality of life (QOL) for individuals with CP 102 . In particular, CP pain is associated with increased fatigue, sleep disturbance, anxiety and depressive symptoms, lower general health status, and reduced physical and role functioning.…”

Section: Pain Complications Of Chronic Pancreatitismentioning

confidence: 99%

Chronic Pancreatitis in the 21st Century - Research Challenges and Opportunities

et al. 2016

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A workshop was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to focus on research gaps and opportunities in chronic pancreatitis (CP) and its sequelae. This conference marked the 20th year anniversary of the discovery of the cationic trypsinogen (PRSS1) gene mutation for hereditary pancreatitis. The event was held on July 27, 2016, and structured into 4 sessions: (1) pathophysiology; (2) exocrine complications; (3) endocrine complications; and (4) pain. The current state of knowledge was reviewed; many knowledge gaps and research needs were identified that require further investigation. Common themes included the need to design better tools to diagnose CP and its sequelae early and reliably, identify predisposing risk factors for disease progression, develop standardized protocols to distinguish type 3c diabetes mellitus from other types of diabetes and design effective therapeutic strategies through novel cell culture technologies, animal models mimicking human disease, and pain management tools. Gene therapy and cystic fibrosis conductance regulator (CFTR) potentiators as possible treatments for CP were discussed. Importantly, the need for chronic pancreatitis endpoints and intermediate targets for future drug trials was emphasized.

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Diagnosis and Management of Chronic Pancreatitis

Singh

Yadav

Garg

2019

JAMA

323

195

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hronic pancreatitis (CP) is a chronic progressive disease with an annual incidence of 5 to 8 and prevalence of 42 to 73 cases per 100 000 adults in the United States. 1-3 Prevalence rates varying from 36 to 125 per 100 000 population have been reported from Japan, China, and India, of which India has the highest prevalence. 4,5 Chronic pancreatitis is characterized by fibrosis and inflammation of the pancreas in individuals with genetic, environmental, and other risk factors such as hypertriglyceridemia. Chronic pancreatitis is characterized by pancreatic atrophy, fibrosis, ductal strictures and distortion, calcifications, dysplasia, exocrine insufficiency and diabetes, and chronic pain. 6 This review summarizes current evidence regarding risk factors, pathophysiology, clinical features, diagnostic evaluation, treatment, and prognosis of CP. MethodsWe searched PubMed for relevant English-language articles published from January 1, 2000, to July 1, 2019. Search terms included chronic pancreatitis and each of the following:

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Pain severity reduces life quality in chronic pancreatitis: Implications for design of future outcome trials

Cited by 89 publications

References 25 publications

Quality of Life in Chronic Pancreatitis is Determined by Constant Pain, Disability/Unemployment, Current Smoking, and Associated Co-Morbidities

Quality of Life in Chronic Pancreatitis is Determined by Constant Pain, Disability/Unemployment, Current Smoking, and Associated Co-Morbidities

Chronic Pancreatitis in the 21st Century - Research Challenges and Opportunities

Diagnosis and Management of Chronic Pancreatitis

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