Predictors of Change in Pain and Physical Functioning Among Post-Menopausal Women With Recurrent Pain Conditions in the Women's Health Initiative Observational Cohort

JOURNAL OF PAIN

卷:13

Article

Braden, Jennifer Brennan¹  Young, Alicia²  Sullivan, Mark D.¹  Walitt, Brian³  LaCroix, Andrea Z.^2,4  Martin, Lisa⁵ 

[1] Univ Washington, Dept Psychiat & Behav Sci, Sch Med, Seattle, WA 98195 USA

[2] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA

[3] Washington Hosp Ctr, Washington, DC 20010 USA

[4] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA

[5] George Washington Univ, Dept Med, Washington, DC USA

关键词: Pain;    obesity;    opioid;    women;    longitudinal;    cohort;   

DOI  :  10.1016/j.jpain.2011.10.007

来源: Elsevier

【 摘 要 】

Pain complaints are commonly reported symptoms among postmenopausal women and can have significant effects on health-related quality of life. We sought to identify medical and psychosocial factors that predict changes in pain and overall physical functioning over a 3-year period among postmenopausal women with recurrent pain conditions. We examined data from postmenopausal women age 50 to 79 with recurrent pain conditions (low back pain, neck pain, headache or migraines, or joint pain or stiffness) over a 3-year period using the Women's Health Initiative Observational Study Cohort (N = 67,963). Multinomial logistic regression models controlling for demographic and clinical characteristics were used to identify baseline predictors of change in the SF-36 subscales for pain and physical functioning between baseline and 3-year follow-up. Body mass index (BMI) was associated with worsening of pain (OR [95% Cl] 1.54 [1.45-1.63] for BMI >= 30) and physical functioning (1.83 [1.71-1.95] for BMI >= 30). A higher reported number of nonpain symptoms, higher medical comorbidity, and a positive screen for depression (1.13 [1.05-1.22] for worsened pain) were also associated with worsening of pain and physical functioning. Baseline prescription opioid use was also associated with lack of improvement in pain (OR .42, 95% Cl .36-.49) and with worsened physical functioning (1.25 [1.04-1.51]). Perspective: This study presents prospective data on change in pain and physical functioning in postmenopausal women over a 3-year period. Our results suggest depression, nonpain physical symptoms, obesity, and possibly opioid treatment are associated with worse long-term pain outcomes in this population. (C) 2012 by the American Pain Society

【 授权许可】

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