Chronic pain: epidemiology and social demographic characteristics of patients of Pain Clinic in the Surgery Center
Abstract A cross-sectional study focused on the prevalence epidemiology of the pain syndromes was carried out in a specialized department of pain. At admission to clinic 2521 patients answered the questionnaire, developed in the department. We determined that most patients were males (60.4%), in working age age (76.4%), with higher education (60.9%). Most common complaints were back pain (46.5%), headaches (22.6%) and pain in joints (21.4%). 88.1% patients suffered from chronic pain, that lasted 1–5 years in 26.7% and more than 5 years in 28.9%. Substantially most patients admitted high pain descriptors – 76% assessed their pain intensity 5 scores measured with a visual analogue scale (VAS). More than 95% experienced chronic daily pain which intensity was 5 scores in 59.5%. There is certain connection between pain intensity and marital status: pain was less intensive in single people (4.52), a little more intensive – in married (4.92) and divorced (5.2), the highest intensity was noted in widowed (6.23). One in five patients (19.1%) called an ambulance or experienced emergency management within the last year. More than 60% patients use analgesics on a regular basis: one in three (32.2%) – daily, 30.2% – several times a week. More than 50% turned for medical help for 3 specialists: 38.9% were consulted by 4–10 doctors, 8.8% – 10 specialists. Pharmaceutical treatment included non-steroidal anti-inflammatory drugs (NSAIDs) (41.2%), nonspecific metabolic therapy (25.6%) and central muscle relaxant (20.4%), whereas adjuvant analgesics was used in 12.7%.
Keywords:pain, chronic pain, pain syndromes prevalence study, pain syndromes epidemiology, department of pain
Clin. Experiment. Surg. Petrovsky J. 2016. № 3. Р. 36–43.
Received: 21.04.2016. Accepted: 20.06.2016.
References
1. Mersky H., Bogduk N. Classification of Chronic Pain, 2nd edition. Seattle: IASP Press, 1994: 6–164.
2. Kukushkin M.L., Hitrov N.K. General pathology of pain. Moscow: Meditsina. 2004: 142 р. (in Russian)
3. Medvedeva L.A. Diagnosis and treatment of acute and chronic pain cervical-cranial localization: Diss: Moscow, 2010: 48 р. (in Russian)
4. Rowbotham M.C. In: Pain 2002 - an updated review. A.M. Giamberardino (ed.). Seattle: IASP Press, 2002: 76–165.
5. Cibuljak V.N., Zagorul'ko O.I., Kartavenko S.S., Alisov A.P. "Pain Clinic" in the middle of surgery. Palliativnaja medicina i reabilit [Palliative Medicine and Rehabilitation]. 1996; Vol. 1: 1–12. (in Russian)
6. Zagorul'ko O.I., Gnezdilov A.V., Medvedeva L.A., Samojlova N.V. The necessity and possibilities of the antipain help organization in multyprofile clinics. Khirurghia. Zhournal im. N.I. Pirogova [Surgery. The journal named after N.I. Pirogov]. 2013; Vol. 1: 13–6. (in Russian)
7. Zagorulko O.I., Gnezdilov A.V., Samoylova N.V., Medvedeva L.A. Multidisciplinary approach in pain treatment in Russia. Eur J Pain. 2011; Vol. 5 (1): 186.
8. Yaкhno N.N., Kukushkin M.L., Churyukanov M.V., Syrovegin A.V. The results of open multicentral study «Meridian» for assessment of pain syndromes prevalence in ambulatory and therapeutic preferences of physicians/ Rossiyskiy zhurnal boli [Russian Journal of Pain]. 2012; Vol. 3–4: 10–4. (in Russian)
9. Zagorul'ko O.I., Medvedeva L.A., Gnezdilov A.V., et al. Epidemiology of pain: a cross-sectional study of the prevalence of different types of pain syndromes in patients pain therapy department. Rossiyskiy zhurnal boli [Russian Journal of Pain]. 2015. Vol. 3–4: 41–7. (in Russian)
10. Casati A., Sedefov R., Pfeiffer-Gerschel T. Misuse of medicines in the European Union: a systematic review of the literature. Eur Addict Res. 2012; Vol. 18 (5): 228–45.
11. Eriksen J., Jensen M.K., Sjogren P. et al. Epidemiology of chronic non-malignant pain in Denmark. J Pain. 2003; Vol. 106: 221–8.
12. Hans G., Masquelier E., De Cock P. The diagnosis and management of neuropathic pain in daily practice in Belgium: an observational study. BMC Public Health. 2007; Vol. 7: 170–8.
13. Kerr S., Fairbrother G., Crawford M., et al. Patient characteristics and quality of life among a sample of Australian chronic pain clinic attendees. Int Med J. 2004; Vol. 34: 403–9.
14. Martini C., Olofsen E., Yassen A., et al. Pharmacokinetic- pharmacodynamic modeling in acute and chronic pain: an overview of the recent literature. Expert Rev Clin Pharmacol. 2011; Vol. 4 (6): 719–28.
15. Neville A., Peleg R., Singer Y., et al. Chronic pain: a population-based study. Isr Med Assoc J. 2008; Vol. 10: 660–76.
16. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015; Vol. 22: 743–800.
17. Davydov O.S. The prevalence of pain syndromes, and their impact on quality of life in the world and in Russia, according to a study of the global burden of disease for the period from 1990 to 2013. Rossiyskiy zhurnal boli [Russian Journal of Pain]. 2015. Vol. 3–4: 11–8. (in Russian)
18. Medvedeva L.A., Zagorul'ko O.I., Gnezdilov A.V., Samojlova N.V. Analysis of uptake of patients with headaches to a specialized pain clinic. Anesthesia opportunities. Lechenie zabolev. nervnoj sistemy. [Treatment of Nervous System Diseases]. 2012; Vol. 2 (10): 45–6. (in Russian)
19. Ulitina E.V., Ledneva O.V., Zhirnova O.L. Statistics: textbook. Moscow: Sinergiya, 2013: 320 р. (in Russian)
20.Mosejkin I.A. Gender-specific tolerance of pain in dorsopathies. Trudnyj pacient [Difficult Patient]. 2010; Vol. 8 (N 4): 32–4. (in Russian)
21. Ruau D., Liu L.Y., Clark J.D., et al. Sex differences in reported pain across 11,000 patients captured in electronic medical records. J Pain. 2012; Vol. 13: 228–34.
22. Kostova V., Koleva M. Back disorders (low back pain, cervicobrachial and lumbosacral radicular syndromes) and some related risk factors. J Neurol. Sci. 2001; Vol. 15 (192): 17–25.
23. Vallerand A.H., Polomano R.C. The relationship of gender to pain. Pain Manage Nurs. 2000; Vol. 1 (3): 8–15.
24. Cleeland C.S., Gonin R., Hatfield A.K., et al. Pain and Its Treatment in Outpatients with Metastatic Cancer. Engl J Med. 1994; Vol. 330 (9): 592–6.
25. Defrin R., Shramm L., Eli I. Gender role expectations of pain is associated with pain tolerance limit but not with pain threshold. J Pain. 2009; Vol. 145 (1–2): 230–6.
26. Wise E.A., Price D.D., Myers C.D., et al. Gender role expectations of pain: relationship to experimental pain perception. J Pain. 2002; Vol. 96 (3): 335–42.
27. Aкhmadeeva L.R., Zakirova Е.N., Voevodin V.A., Magzhanov R.V. The impact of social factors, clinical characteristics and comorbid disorders on the quality of life of patients with tension-type headache. Bjul. sibirskoj mediciny [Bulletin of the Siberian Medicine] 2008; Vol. 5: 34–40.
28. Yaкhno N.N., Kukushkin M.L. Chronic pain: medical- biological and socio-economic aspects. Vestnik Rossiyscoy akademii meditzinskikh nauk [Bulletin of RAMS]; 2012; Vol. 9: 54–8. (in Russian)
29. Zhezlov M.M., Levin O.S. Diagnosis and treatment of vertebral lumbosacral radiculopathy. Sovr. terapija v psihiatr. i nevrol. [Current Therapy in Psychiatry and Neurology]. 2012; Vol. 4: 31–6. (in Russian)
30. Tarulli A.W., Raynor E.M. Lumbosacral radiculopathy. Neurol Clin. 2007; Vol. 25 (2): 387–405.
31. BreivikH.,CollettB.,VentafriddaV.,etal.Surveyofchronic pain in Europe: Prevalence, impact on daily life, and treatment. Eur J Pain. 2006; Vol. 10: 287–333.