Living with disabling chronic pain: results from a face-to-face cross-sectional population-based study

BMJ Open. 2018 Nov 12;8(11):e020913. doi: 10.1136/bmjopen-2017-020913.

Abstract

Objectives: To estimate the prevalence of disabling chronic pain (DCP) in Spanish adults, to analyse its characteristics, to determine its multimorbidity and to identify its associated factors.

Settings: 2011 Andalusian Health Survey, a cross-sectional population survey based on face-to-face home interviews.

Participants: 6507 people aged 16 years or older and living in Andalusia, Spain.

Outcomes: The response variable was disabling chronic pain. Multivariate multinomial logistic regression models were used to analyse the association of factors with disabling chronic pain. The sample design was considered throughout the statistical analysis.

Results: The prevalence of disabling chronic pain in the Spanish adult population was 11.36% (95% CI 11.23 to 11.49), while that of non-disabling chronic pain was 5.67% (95% CI 5.57 to 5.77). Disabling chronic pain was associated with high multimorbidity (especially in women (51%) and in the elderly (70%) with three or more additional chronic diseases), as well as with disadvantaged social status (such as female gender (OR=2.12), advanced age (OR10-year increase=1.28), unemployment (OR=1.33), manual work (OR=1.26), low income (OR=1.14) and reduced emotional social support (OR=1.04)). Other influential factors were tobacco consumption (OR=1.42), sleeping ≤7 hours (OR=1.2)], environmental or work conditions (OR=1.16) and quality of life (ORmental=1.21, ORphysical=2.37).

Conclusions: The population with disabling chronic pain was associated with multimorbidity, vulnerable social status and an impaired quality of life. In contrast, the population with non-disabling chronic pain showed almost no differences when compared with the population without chronic pain. The association between DCP and mental disorders highlights the need for psychosocial services in the management of chronic pain.

Keywords: activity restriction; chronic pain; cross-sectional study; disability; multimorbidity; quality Of life.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / psychology
  • Adult
  • Chronic Pain / epidemiology*
  • Chronic Pain / psychology
  • Cross-Sectional Studies
  • Disabled Persons / psychology
  • Disabled Persons / statistics & numerical data*
  • Factor Analysis, Statistical
  • Female
  • Health Status*
  • Humans
  • Male
  • Multimorbidity
  • Prevalence
  • Quality of Life*
  • Sex Distribution
  • Social Support
  • Socioeconomic Factors
  • Spain / epidemiology