Characterization of complex chronic pain patients

Characterization of complex chronic pain patients AbstractAimsTreatment of the most complex chronic pain patients, often not accepted in regular pain management programs, remains a challenge.To beable todesign interventions for these patients we must know what characterize them. The aim of this study was to characterize a subgroup of pain patients, treated in our in-patient rehabilitation programme, organized at the University Hospital in Uppsala, the only tertiary treatment for pain patients in Sweden.MethodsThe study was approved by the Regional Ethical Review Board in Uppsala (Dnr 2010/182). Seventy-two patients, consecutive new referrals seen at the rehabilitation program in 2008–2010 were enrolled and examined with a 41-item questionnaire of symptoms other than pain. The 41 symptoms were listed on an ordinal scale from 0–10, with 0–no problems and 10–severe problem. The mean pain intensity within the preceding 24-h was assessed using an 11-point NRS, numeric rating scale from 0–no problems to 10–severe problems. Information about drug-consumption was obtained from the medical record. The opioid medication was translated to morphine-equivalents dos using EAPC (European Association for Palliative Care) conversion table.ResultsSeventy-two patients were enrolled and screened, 39% men and 61% woman. Median age 45 years (range 20–70). Seventy-four percent of patients were treated with opioids, 15 patients with more than one opioid. They all reported high pain intensity, the four patients with doses over 150 mg MEq reported pain 5–8. There was no correlation between the dose of opioids and pain intensity. The patients reported 22 symptoms (median) other than pain. The number of symptoms reported using this scaleina normal population is three–four. The most common symptoms reported were lethargy, tiredness, concentration difficulties and headache reported by over 80%. Sleeping disorders and tiredness were considered as the two most problematic symptom to deal with. We found no correlation between the degree of pain and presence and severity of symptoms reported. Number of symptoms reported diminished when the dose of opioids increased.ConclusionsThe pain patient considered too complex for regular pain-management programs are characterized by reporting many symptoms other than pain. High pain intensity or high opioid-dose does not correlate to presence or severity of other symptoms, and high dose of opioids does not have a connection to low pain intensity. Many of the symptoms commonly reported – lethargy, tiredness, concentration difficulties and headache are real obstacles for successful rehabilitation, and have to be dealt with to achieve successful results. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

Characterization of complex chronic pain patients

Loading next page...
 
/lp/degruyter/characterization-of-complex-chronic-pain-patients-MOG6B0gtGO
Publisher
De Gruyter
Copyright
© 2015 Scandinavian Association for the Study of Pain
ISSN
1877-8860
eISSN
1877-8879
D.O.I.
10.1016/j.sjpain.2015.04.010
Publisher site
See Article on Publisher Site

Abstract

AbstractAimsTreatment of the most complex chronic pain patients, often not accepted in regular pain management programs, remains a challenge.To beable todesign interventions for these patients we must know what characterize them. The aim of this study was to characterize a subgroup of pain patients, treated in our in-patient rehabilitation programme, organized at the University Hospital in Uppsala, the only tertiary treatment for pain patients in Sweden.MethodsThe study was approved by the Regional Ethical Review Board in Uppsala (Dnr 2010/182). Seventy-two patients, consecutive new referrals seen at the rehabilitation program in 2008–2010 were enrolled and examined with a 41-item questionnaire of symptoms other than pain. The 41 symptoms were listed on an ordinal scale from 0–10, with 0–no problems and 10–severe problem. The mean pain intensity within the preceding 24-h was assessed using an 11-point NRS, numeric rating scale from 0–no problems to 10–severe problems. Information about drug-consumption was obtained from the medical record. The opioid medication was translated to morphine-equivalents dos using EAPC (European Association for Palliative Care) conversion table.ResultsSeventy-two patients were enrolled and screened, 39% men and 61% woman. Median age 45 years (range 20–70). Seventy-four percent of patients were treated with opioids, 15 patients with more than one opioid. They all reported high pain intensity, the four patients with doses over 150 mg MEq reported pain 5–8. There was no correlation between the dose of opioids and pain intensity. The patients reported 22 symptoms (median) other than pain. The number of symptoms reported using this scaleina normal population is three–four. The most common symptoms reported were lethargy, tiredness, concentration difficulties and headache reported by over 80%. Sleeping disorders and tiredness were considered as the two most problematic symptom to deal with. We found no correlation between the degree of pain and presence and severity of symptoms reported. Number of symptoms reported diminished when the dose of opioids increased.ConclusionsThe pain patient considered too complex for regular pain-management programs are characterized by reporting many symptoms other than pain. High pain intensity or high opioid-dose does not correlate to presence or severity of other symptoms, and high dose of opioids does not have a connection to low pain intensity. Many of the symptoms commonly reported – lethargy, tiredness, concentration difficulties and headache are real obstacles for successful rehabilitation, and have to be dealt with to achieve successful results.

Journal

Scandinavian Journal of Painde Gruyter

Published: Dec 29, 2017

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

Monthly Plan

  • Read unlimited articles
  • Personalized recommendations
  • No expiration
  • Print 20 pages per month
  • 20% off on PDF purchases
  • Organize your research
  • Get updates on your journals and topic searches

$49/month

Start Free Trial

14-day Free Trial

Best Deal — 39% off

Annual Plan

  • All the features of the Professional Plan, but for 39% off!
  • Billed annually
  • No expiration
  • For the normal price of 10 articles elsewhere, you get one full year of unlimited access to articles.

$588

$360/year

billed annually
Start Free Trial

14-day Free Trial