The Relationship between Cognitive and Emotional Factors and Healthcare and Medication Use in People Experiencing Pain: A Systematic Review

Huysmans, Eva; Leemans, Liesbeth; Beckwée, David; Nijs, Jo; Ickmans, Kelly; Moens, Maarten; Goudman, Lisa; Buyl, Ronald; Putman, Koen; Coppieters, Iris

doi:10.3390/jcm9082486

Cited by 20 publications

(23 citation statements)

References 162 publications

(773 reference statements)

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“…These findings align with previous prognostic studies analysing factors associated with general healthcare utilization. 7,15,16,18,[21][22][23][24] Notably, while the mean scores for neuroticism (and all other personality trait scores) for all trajectory groups were low compared to population norms, 49 they were significantly higher in the high stable trajectory group than the other trajectory groups. Higher neuroticism reflects a tendency to experience negative emotions, 70,71 and other studies have shown that neuroticism correlates with lower quality of life and reported severity of physical symptoms, 72 both of which are independently associated with high healthcare utilization.…”

Section: Multidimensional Profilingmentioning

confidence: 88%

“…Several factors are associated with high levels of healthcare utilization due to pain. 7,15 These include older age, 7,15,16 low socioeconomic status, 7,16 marital status (people never married seek healthcare less often than those married) 17 and being female, 7,15,18 high pain intensity, [18][19][20] high level of disability, 18,19,21 number of pain sites, 21 comorbidity, 16 body mass index (BMI), poor general health, 15,16,22 negative health beliefs (health anxiety, catastrophizing, fear avoidance), 15,22,23 being retired or unemployed, 8 and previous healthcare use. 22,24 Personality has also been suggested as an important factor in the development of pain and coping strategies -including healthcare-seeking.…”

Section: Video Abstractmentioning

confidence: 99%

“… 22 , 24 Personality has also been suggested as an important factor in the development of pain and coping strategies – including healthcare-seeking. 25 However, these findings are inconsistent and contradictory across studies, 7 , 21 , 23 , 26 and few studies have explored factors associated with musculoskeletal healthcare utilization.…”

Section: Introductionmentioning

confidence: 99%

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Trajectories of Musculoskeletal Healthcare Utilization of People with Chronic Musculoskeletal Pain – A Population-Based Cohort Study

Mose¹,

Smith²,

Andersen³

et al. 2021

CLEP

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Background and Aim Chronic musculoskeletal pain is common and associated with more general healthcare-seeking. However, musculoskeletal-related healthcare utilization is under-explored. This study aimed to explore, describe and profile trajectories of long-term musculoskeletal healthcare for people reporting chronic musculoskeletal pain. Methods This exploratory prognostic cohort study combined survey and national health register data from a representative group of adult Danes reporting chronic musculoskeletal pain (N = 2929). Trajectories of long-term musculoskeletal healthcare use were generated using latent class growth analysis. Types of healthcare-seeking, individual, sociodemographic, health, belief and work-related factors were used to describe and profile identified trajectories. Results We identified five distinct trajectories of long-term musculoskeletal healthcare utilization (low stable, low ascending, low descending, medium stable and high stable). The low stable trajectory group (no or almost no annual contacts) represented 39% of the sample, whereas the high stable trajectory group (consistent high number of annual contacts) represented 8%. Most healthcare-seeking was in primary healthcare settings (GP/physiotherapy/chiropractor). Opioid consumption was primarily in the high stable trajectory group, and surgery was rare. There were statistically significant differences across the five trajectory groups in individual, sociodemographic, health, belief and work-related profiles. Conclusion Long-term use of musculoskeletal healthcare services varied in this chronic musculoskeletal pain population. Almost 40% coped without seeking care, whereas 8% had consistent high use of healthcare services. Chronic musculoskeletal pain was mostly managed in primary care settings, which aligns with musculoskeletal guidelines, as did the use of pain medication and surgery. People with different musculoskeletal healthcare trajectories had different individual, sociodemographic, health, belief and work-related profiles.

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Section: Multidimensional Profilingmentioning

confidence: 88%

Section: Video Abstractmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Trajectories of Musculoskeletal Healthcare Utilization of People with Chronic Musculoskeletal Pain – A Population-Based Cohort Study

Mose¹,

Smith²,

Andersen³

et al. 2021

CLEP

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“…12 A recent systematic review found consistent associations between pain-related anxiety/distress and treatment-seeking behaviors, including use of pain medication. 13 Baseline pain catastrophizing was a significant predictor of future pain-related office visits and total medical costs for patients with musculoskeletal pain. 14 Additionally, pain catastrophizing partially mediates the relationship between pain intensity and number of health care visits, 15 confirming that patients’ psychological and behavioral responses to their symptoms influence their healthcare utilization beyond their degree of symptomatology alone.…”

Section: Introductionmentioning

confidence: 97%

Pain acceptance predicts healthcare utilization in women with chronic pelvic pain

Kreher

Gubbels

2022

Journal of Endometriosis and Pelvic Pain Disorders

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Background: Chronic pelvic pain (CPP) in women is common and costly, and little is known about patient characteristics predicting healthcare utilization within this population. The present study examined the role of pain acceptance and pain catastrophizing, assessed prior to treatment initiation, in predicting future uptake of medical and surgical interventions specifically for pain management. Methods: Our sample comprised women referred to a tertiary gynecological center. Baseline pain catastrophizing and pain acceptance scores were compared across each major medication class and surgery type, as well as across the total number of medication classes and the total number of surgery types using analysis of variance (ANOVA). We then performed multivariable analyses for the association between pain catastrophizing and pain acceptance and treatment utilization by controlling for potential confounders. Results: Three hundred eighteen patients met inclusion criteria. Pain catastrophizing was associated with increased likelihood of neuromodulator prescription, while pain acceptance was associated with reduced likelihood of neuromodulator prescription and fewer medication classes prescribed. Overall, no associations between pain catastrophizing and surgeries were observed, while pain acceptance was significantly associated with lower risk of hysterectomy/oophorectomy. Conclusion: Pain acceptance was a robust predictor of number of medication classes prescribed and use of radical surgeries even when controlling stringently for confounders. It is worth considering routine assessment of pain acceptance early in treatment of CPP to identify those more at-risk of higher treatment utilization, and potentially mitigate this through engagement with appropriate behavioral therapies.

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“…The cost of medical treatment and lost productivity due to pain exceeds US $635 billion each year in the United States, more than the cost of treating cardiovascular disease, cancer, or diabetes [ 5 ]. Chronic pain also significantly affects an individual’s quality of life, negatively impacting their ability to engage in day-to-day activities, and increasing risk for depression, anxiety, and opioid dependence [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

A Novel Method for Digital Pain Assessment Using Abstract Animations: Human-Centered Design Approach

Perdomo¹,

Rao²,

Jonassaint³

2022

JMIR Hum Factors

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Background Patients with chronic pain face several challenges in using clinical tools to help them monitor, understand, and make meaningful decisions about their pain conditions. Our group previously presented data on Painimation, a novel electronic tool for communicating and assessing pain. Objective This paper describes the human-centered design and development approach (inspiration, ideation, and implementation) that led to the creation of Painimation. Methods We planned an iterative and cyclical development process that included stakeholder engagement and feedback from users. Stakeholders included patients with acute and chronic pain, health care providers, and design students. Target users were adults with acute or chronic pain who needed clinical assessment and tracking of the course of their pain over time. Phase I (inspiration) consisted of empathizing with users, understanding how patients experience pain, and identifying the barriers to accurately expressing and assessing pain. This phase involved understanding how patients communicate pain symptoms to providers, as well as defining limitations of current models of clinical pain assessment tools. In Phase II (ideate) we conceptualized and evaluated different approaches to expressing and assessing pain. The most promising concept was developed through an iterative process that involved end users and stakeholders. In Phase III (implementation), based on stakeholder feedback from initial designs and prototypes of abstract pain animations (painimations), we incorporated all concepts to test a minimally viable product, a fully functioning pain assessment app. We then gathered feedback through an agile development process and applied this feedback to finalizing a testable version of the app that could ultimately be used in a pain clinic. Results Engaging intended users and stakeholders in an iterative, human-centered design process identified 5 criteria that a pain assessment tool would need to meet to be effective in the medical setting. These criteria were used as guiding design principles to generate a series of pain assessment concept ideas. This human-centered approach generated 8 highly visual painimations that were found to be acceptable and useable for communicating pain with medical providers, by both patients with general pain and patients with sickle cell disease (SCD). While these initial steps continued refinement of the tool, further data are needed. Agile development will allow us to continue to incorporate precision medicine tools that are validated in the clinical research arena. Conclusions A multiphase, human-centered design approach successfully resulted in the development of an innovation that has potential to improve the quality of medical care, particularly for underserved populations. The use of Painimation may especially benefit the medical care of minority populations with chronic and difficult-to-treat pain, such as adults with SCD. The insights generated from this study can be applied to the development of patient-reported outcomes tools that are more patient-centered, engaging, and effective.

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The Relationship between Cognitive and Emotional Factors and Healthcare and Medication Use in People Experiencing Pain: A Systematic Review

Cited by 20 publications

References 162 publications

Trajectories of Musculoskeletal Healthcare Utilization of People with Chronic Musculoskeletal Pain – A Population-Based Cohort Study

Trajectories of Musculoskeletal Healthcare Utilization of People with Chronic Musculoskeletal Pain – A Population-Based Cohort Study

Pain acceptance predicts healthcare utilization in women with chronic pelvic pain

A Novel Method for Digital Pain Assessment Using Abstract Animations: Human-Centered Design Approach

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