The Association Between Pain and Clinical Outcomes in Adolescents With Cystic Fibrosis

Abstract

Context: Pain is a common problem in patients with cystic fibrosis (CF) and in adults is associated with lower quality of life and more pulmonary complications. Less is known about the impact of pain in adolescents with CF.

Objectives: This study aimed to describe pain in an adolescent CF population and to determine if pain at baseline is associated with lower health-related quality of life (HRQoL) and worse pulmonary outcomes at six-month follow-up.

Methods: We administered surveys at baseline and at six months to CF patients aged 12 to 20 years. Analyses included Wilcoxon log-rank tests, Spearman correlations, and linear and logistic regressions.

Results: Seventy-three patients (86.9%) completed the baseline questionnaire and 53 patients (63.1%) completed the six-month follow-up questionnaire. Mean age was 15.6 ± 2.5 and mean FEV₁ was 79 ± 26% predicted; 89% of patients reported pain in the three months before the survey, but in most it was short lived and mild to moderate in severity. Abdominal pain was the most common location. Pain was associated with increased pulmonary exacerbations (odds ratios = 1.99 for every one-point increase on a composite pain scale, P = 0.03) and with lower HRQoL.

Conclusions: Pain in adolescents with CF is associated with lower HRQoL and more pulmonary exacerbations. Greater efforts are needed to manage pain in this population and to determine if treatment of pain improves other outcomes.

Keywords: Cystic fibrosis; pain; quality of life.