NDLI: Short and long-term predictors of pain severity and interference in primary care patients with chronic musculoskeletal pain and depression

Content Provider	Springer Nature : BioMed Central
Author	Rambla, Concepció Aragonès, Enric Pallejà-Millán, Meritxell Tomé-Pires, Catarina López-Cortacans, Germán Sánchez-Rodríguez, Elisabet Miró, Jordi
Abstract	Background Chronic pain and depression are frequent comorbidities in primary care. Depression among other psychosocial factors play a role in the clinical course of chronic pain. Objective To study the short and long-term predictive factors of severity and interference of chronic pain in primary care patients with chronic musculoskeletal pain and major depression. Methods Longitudinal study of a cohort of 317 patients. The outcomes are severity and functional interference of pain (Brief Pain Inventory) measured at 3 and 12 months. We performed multivariate linear regression models to estimate the effects the explanatory baseline variables on the outcomes. Results 83% participants were women; average age was 60.3 years (SD = 10.2). In multivariate models, baseline pain severity predicted pain severity at 3 months (β = 0.53; 95% CI = 0.37–0.68) and at 12 months (β = 0.48; 95% CI = 0.29–0.67). Also, pain > 2 years of evolution predicted long term pain severity (β = 0.91; CI95%=0.11–1.71). Baseline pain interference predicted interference at 3 and 12 months (β = 0.27; 95%CI = 0.11–0.43 and β = 0.21; 95%CI = 0.03–0.40, respectively). Baseline pain severity predicted interference at 3 and 12 months (β = 0.26; 95%CI = 0.10–0.42 and β = 0.20; 95%CI = 0.02–0.39, respectively). Pain > 2 years predicted greater severity and greater interference at 12 months (β = 0.91; CI95%=0.11–1.71, and β = 1.23; CI95%=0.41–2.04). Depression severity predicted more interference at 12 months (β = 0.58; CI95%=0.04–1.11). Occupational status as active worker predicted less interference throughout the follow-up (β=-0.74; CI95%=-1.36 to -0.13 and β=-0.96; CI95%=-1.71 to -0.21, at 3 and 12 months). Currently working also predicts less pain severity at 12 months (β=-0.77; CI95%=1.52 − 0.02). With regard to the psychological variables, pain catastrophizing predicted pain severity and interference at three months (β = 0.03; 95% CI = 0.00-0.05 and β = 0.03; 95% CI = 0.00-0.05), but not at long term. Conclusion In a sample of adults with chronic pain and depression, this primary care study has identified prognostic factors that independently predict the severity and functional interference of pain. If confirmed in new studies, these factors should be targeted for individualized interventions. Trial registration ClinicalTrials.gov (NCT02605278), registered 16/11/2015.
Related Links	https://bmcmusculoskeletdisord.biomedcentral.com/counter/pdf/10.1186/s12891-023-06357-2.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14712474
DOI	10.1186/s12891-023-06357-2
Journal	BMC Musculoskeletal Disorders
Issue Number	1
Volume Number	24
Language	English
Publisher	BioMed Central
Publisher Date	2023-04-05
Access Restriction	Open
Subject Keyword	Orthopedics Rehabilitation Rheumatology Sports Medicine Internal Medicine Epidemiology Primary Health Care Chronic pain Major depression Catastrophizing Longitudinal studies
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Rheumatology
Journal Impact Factor	2.2/2023
5-Year Journal Impact Factor	2.6/2023

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