Disentangling comorbidity in chronic pain: A study in primary health care settings from India.
Adult
Anxiety Disorders
/ epidemiology
Chronic Disease
/ epidemiology
Chronic Pain
/ epidemiology
Comorbidity
Diabetes Mellitus
/ epidemiology
Female
Humans
Hypertension
/ epidemiology
India
/ epidemiology
Male
Mental Health
Middle Aged
Patient Health Questionnaire
Primary Health Care
Self Report
Surveys and Questionnaires
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
26
04
2020
accepted:
10
11
2020
entrez:
30
11
2020
pubmed:
1
12
2020
medline:
8
1
2021
Statut:
epublish
Résumé
The study examined the prevalence, sociodemographic, and clinical correlates of chronic pain among primary care patients in the state of Kerala, India. It also examined the patterns and relationships of chronic physical and mental health conditions with chronic pain. This study is a cross-sectional survey conducted among 7165 adult patients selected randomly by a multi-stage stratified design from 71 primary health centers. The questionnaires administered included Chronic pain screening questionnaire, self-reported Chronic physical health condition checklist, Patient Health Questionnaire-SADS, The Alcohol Use Disorders Identification Test, Fagerström Test for Nicotine Dependence, WHO Disability Assessment Schedule and WHOQOL- BREF for Quality/Satisfaction with Life. The prevalence and comorbid patterns of chronic pain were determined. Logistic regression analysis and generalized linear mixed-effects model was employed to examine the relationship of chronic pain to socio-demographic variables and examined physical and mental health conditions. A total of 1831 (27%) patients reported chronic pain. Among those with chronic pain, 28.3% reported no co-occurring chronic mental or physical illness, 35.3% reported one, and 36.3% reported multi-morbidity. In the multivariate analysis, patients with chronic pain when compared to those without had higher odds of being older, female, having lower education, not living with their family, greater disability, and poor satisfaction with life. Chronic pain was independently associated with both medical (hypertension, diabetes mellitus, tuberculosis, arthritis, and other medical illnesses) and mental health conditions (depressive disorders, anxiety disorders, and tobacco dependence). It showed a varying strength of association and additive effect with increasing number of co-occurring physical and mental illnesses. Chronic pain is a common condition among primary care attendees associated with significant burden of medical and mental health comorbidity. The findings highlight the need to incorporate treatment models that will ensure appropriate management to improve outcomes within the resource constraints.
Identifiants
pubmed: 33253251
doi: 10.1371/journal.pone.0242865
pii: PONE-D-20-12053
pmc: PMC7703899
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0242865Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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