Predictors of Unrelieved Symptoms in All of Us Research Program Participants With Chronic Conditions.
Signs and symptoms
cancer
chronic obstructive pulmonary disease
heart failure
surveys and questionnaires
type 2 diabetes mellitus
Journal
Journal of pain and symptom management
ISSN: 1873-6513
Titre abrégé: J Pain Symptom Manage
Pays: United States
ID NLM: 8605836
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
received:
29
06
2022
revised:
18
08
2022
accepted:
24
08
2022
pubmed:
13
9
2022
medline:
16
11
2022
entrez:
12
9
2022
Statut:
ppublish
Résumé
Over half of American adults are diagnosed with a chronic condition, with an increasing prevalence being diagnosed with multiple chronic conditions. These adults are at higher risk for having unrelieved, co-occurring symptoms, known as symptom clusters. To identify symptom phenotypes of patients diagnosed with four common chronic conditions, specifically, cancer, chronic obstructive pulmonary disease, heart failure, and/or type 2 diabetes mellitus, and to understand factors that predict membership in symptomatic phenotypes. We conducted a retrospective, cross-sectional analysis using participant responses (N=14,127) to All of Us Research Program, a National Institutes of Health biomedical database, survey questions. We performed hierarchical clustering to generate symptom phenotypes of fatigue, emotional distress, and pain and used multinomial regression to determine if demographic, healthcare access and utilization, and health-related variables predict symptom phenotype. Four phenotypes, one asymptomatic or mildly symptomatic and three highly symptomatic (characterized by severe symptoms, severe pain, and severe emotional distress), were identified. The percentage of participants belonging to the severe symptoms phenotype increased with the number of chronic conditions. Most notably, foregoing or delaying medical care and rating mental health as poor or fair increased the odds of belonging to a highly symptomatic phenotype. We found meaningful relationships between demographic, healthcare access and utilization, and health-related factors and symptom phenotypes. With the increasing trends of American adults with one or more chronic conditions and a demand to individualize care in the precision health era, it is critical to understand the factors that lead to unrelieved symptoms.
Identifiants
pubmed: 36096320
pii: S0885-3924(22)00872-7
doi: 10.1016/j.jpainsymman.2022.08.018
pmc: PMC10291890
mid: NIHMS1843027
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
555-566Subventions
Organisme : NIH HHS
ID : OT2 OD026556
Pays : United States
Organisme : NINR NIH HHS
ID : R00 NR017651
Pays : United States
Organisme : NIH HHS
ID : U2C OD023196
Pays : United States
Organisme : NIH HHS
ID : OT2 OD025315
Pays : United States
Organisme : NIH HHS
ID : U24 OD023121
Pays : United States
Organisme : NIH HHS
ID : OT2 OD026549
Pays : United States
Organisme : NIH HHS
ID : OT2 OD025337
Pays : United States
Organisme : NIH HHS
ID : OT2 OD025277
Pays : United States
Organisme : NIH HHS
ID : OT2 OD026555
Pays : United States
Organisme : NIH HHS
ID : OT2 OD026550
Pays : United States
Organisme : NIH HHS
ID : OT2 OD023205
Pays : United States
Organisme : NIH HHS
ID : OT2 OD026557
Pays : United States
Organisme : NIH HHS
ID : OT2 OD026554
Pays : United States
Organisme : NIH HHS
ID : U24 OD023163
Pays : United States
Organisme : NIH HHS
ID : U24 OD023176
Pays : United States
Organisme : NIH HHS
ID : OT2 OD026548
Pays : United States
Organisme : NIH HHS
ID : OT2 OD026551
Pays : United States
Organisme : NINR NIH HHS
ID : P30 NR016587
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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