The association between pain characteristics, pain catastrophizing and health care use - Baseline results from the SWEPAIN cohort

Abstract

Background and aim: Pain is common and adds to the global burden of disease. However, individuals suffering from pain are a heterogeneous group in terms of pain spreading, intensity and duration. While pain influences overall health care consultation not everyone with pain consult health care. To be able to provide health care matching the patients' needs increased knowledge about what factors determines the decision to consult health care is essential. The aim of this study was to explore the combined importance of pain spreading, intensity, duration and pain catastrophizing for consulting health care.

Methods: In this cross-sectional study we used population based survey data from southeast Sweden (SWEPAIN) including 7792 individuals' aged 16-85 reporting pain. We used Modified Poisson regressions to analyse factors of importance related to the decision to consult health care.

Results: High and moderate pain intensity, as compared to low, increases the probability of consulting health care (High PR=1.7 [95% CI 1.51-1.88], moderate PR=1.2 [1.15-1.41]). Having widespread pain, as compared to localised pain, increased the probability of consulting health (PR=1.2 [1.03-1.36). Pain duration was not associated with increased probability of consulting health care (PR=1.0 CI0.88-1.07). However an interaction (p=0.05) between pain duration and pain catastrophizing beliefs was seen indicating a combined importance of the two when consulting health care.

Conclusion: Our result suggests that pain intensity, pain spreading and pain catastrophizing independently influence the decision to consult health care while there is an interaction effect between pain duration and pain catastrophizing beliefs where the importance of pain catastrophizing believes differ with pain duration; the importance of pain catastrophizing believes differ with pain duration.

Implications: Treatment and rehabilitation strategies should incorporate this finding in order to meet the individual's needs focusing on the biopsychosocial model within health care focusing not only on actual pain reliefs but also on for example acceptance and behavioural changes.

Keywords: Chronic pain; Health care utilisation; Pain catastrophizing.