Disentangling comorbidity in chronic pain: A study in primary health care settings from India.

Tytuł:: Disentangling comorbidity in chronic pain: A study in primary health care settings from India.
Autorzy:: Desai G; Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
T S J; Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
G SK; National Health Mission (Kerala), Thiruvananthapuram, India.
L M; National Health Mission (Kerala), Thiruvananthapuram, India.
G R G; National Health Mission (Kerala), Thiruvananthapuram, India.
Bajaj A; Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
K T; Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
Chaturvedi SK; Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
Źródło:: PloS one [PLoS One] 2020 Nov 30; Vol. 15 (11), pp. e0242865. Date of Electronic Publication: 2020 Nov 30 (Print Publication: 2020).
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: San Francisco, CA : Public Library of Science
MeSH Terms:: Comorbidity*
Anxiety Disorders/*physiopathology
Chronic Pain/*physiopathology
Diabetes Mellitus/*physiopathology
Adult ; Anxiety Disorders/epidemiology ; Chronic Disease/epidemiology ; Chronic Pain/epidemiology ; Diabetes Mellitus/epidemiology ; Female ; Humans ; Hypertension/epidemiology ; Hypertension/physiopathology ; India/epidemiology ; Male ; Mental Health ; Middle Aged ; Patient Health Questionnaire ; Primary Health Care ; Self Report ; Surveys and Questionnaires
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Entry Date(s):: Date Created: 20201130 Date Completed: 20210107 Latest Revision: 20210107
Update Code:: 20240105
PubMed Central ID:: PMC7703899
DOI:: 10.1371/journal.pone.0242865
PMID:: 33253251
: Czasopismo naukowe

Pełny tekst

Objectives: 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.
Methods: 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.
Results: 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.
Conclusions: 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.
Competing Interests: The authors have declared that no competing interests exist.

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