Prevalence and characteristics of chronic pain in survivors of critical illness and impact on daily life and treatment practices

Vincenzo Damico; Mariangela Vanalli; Liana Murano

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Abstract

OBIETTIVO: Lo scopo di questo studio era di valutare la prevalenza e le caratteristiche del dolore cronico (DC) nei pazienti dimessi dalla Terapia Intensiva. L'obiettivo secondario era di valutarne l'impatto sulla qualità della vita e sulle scelte di trattamento terapeutico.

METODI: Lo studio ha seguito un disegno trasversale. Dodici mesi dopo la dimissione dalla terapia intensiva, i pazienti sono stati contattati per un’intervista. Sono stati somministrati due questionari (Brief Pain Inventory e Euroqol 5D Instrument) per valutare il DC e la qualità della vita. I dati sono stati ottenuti tra il 20 giugno e il 20 dicembre 2019.

RISULTATI: 118 pazienti hanno partecipato allo studio. Un tasso di prevalenza complessivo del 26.3% (n= 31) è stato trovato nella popolazione in studio. La più alta prevalenza è stata osservata nei pazienti con range di età 40-55 anni (41.9%) (n= 13). Il tasso di prevalenza negli uomini era del 26.3%, uguale a quello nelle donne (p= .99). L'intensità del dolore era simile tra donne (5.6) e uomini (5.8) (p= .35). Ginocchia (15.3%), gambe (12.7%) e articolazioni minori (12.7%) sono state le sedi più comuni di dolore. La qualità di vita percepita (EQ VAS) era 74.9 (+9.7) nei pazienti senza DC e 58.2 (+9.2) nei pazienti con dolore (p <.001).

DISCUSSIONE: Il dolore ha un impatto negativo sui pazienti. Pertanto, vogliamo sottolineare la necessità di adottare un approccio multidisciplinare per migliorare le condizioni del paziente, considerando sia i trattamenti farmacologici che le misure non farmacologiche.

PAROLE CHIAVE: Dolore cronico, terapia intensiva, prevalenza, qualità della vita, questionari

Parole chiave

Dolore Cronico terapia intensiva prevalenza qualità di vita questionari Chronic pain questionnarie intensive care unit prevalence

Come citare

Damico, V., Vanalli, M., & Murano, L. (2021). Prevalenza e caratteristiche di dolore cronico nei pazienti dimessi dalla Terapia Intensiva e analisi dell’impatto sulla vita quotidiana e sulle scelte di trattamento terapeutico. PROFESSIONI INFERMIERISTICHE, 73(4), 288–295. Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/858

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Riferimenti

Andrasik, F., Grazzi, L., Usai, S., Bussone, G. (2007). Pharmacological treatment compared to behavioural treatment for juvenile tension-type headache: results at two-year follow-up. Neurol Sci, 28 Suppl 2, S235-8.
Battle, C. E., Lovett, S., & Hutchings, H. (2013). Chronic pain in survivors of critical illness: a retrospective analysis of incidence and risk factors. Crit Care, 29-17(3), R101.
Breivik, H., Collett, B., Ventafridda, V., Cohen, R., Gallacher, D. (2006). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. Eur J Pain, 10, 287-333.
Brennan, M. J., & Lieberman, J. A. (2009). Sleep disturbances in patients with chronic pain: Effectively managing opioid analgesia to improve outcomes. Curr Med Res Opin, 25(5), 1045–55.
Bonezzi, C., Nava, A., Barbieri, M., Bettaglio, R., De-martini, L., Miotti, D., Paulin, L. (2002). Validazione della versione italiana del Brief Pain Inventory nei pazienti con dolore cronico. Minerva Anestesiologica, 68(7-8), 607-11.
Bouhassira, D., Lantéri-Minet, M., Attal, N., Laurent, B., Touboul, C. (2008). Prevalence of chronic pain with neuropathic characteristics in the general population. Pain, 136, 380-7.
Butler, A. C., Chapman, J. E., Forman, E. M., Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev, 26, 17–31.
Cardenas, D. D., Bryce, T. N., Shem, K., Richards, J. S., Elhefni, H. (2004). Gender and minority differences in the pain experiences of people with spinal cord injury. Arch Phys Med Rehabil, 85, 1774–1781.
Damico, V., Cazzaniga, F., Murano, L., Ciceri, R., Nattino, G., Dal Molin, A. (2018). Impact of a Clinical Therapeutic Intervention on Pain Assessment, Management, and Nursing Practices in an Intensive Care Unit: A before-and-after Study. Pain Management Nursing, 19(3), 256-266.
Damico, V., Murano, L., Cazzaniga, F., Dal Molin, A. (2018). Pain prevalence, severity, assessment and management in hospitalized adult patients: a results of a multicenter cross sectional study. Ann Ist Super Sanità, 54(3), 194-200.
Damico, V., Murano, L., Manzoni, L., Riggio, M., Dal Molin, A. (2020). The effects of a clinical therapeutic intervention in pain assessment and management in surgical ICU patients: a before-and-after intervention study on pain intensity and use of analgesia. Prof Inferm, 73(2):106-115.
Demirel, G., Yilmaz, H., Gencosmanoglu, B., Kesiktas¸ N. (1998). Pain following spinal cord injury. Spinal Cord, 36, 25–28.
Demoro, G., Damico, V., Murano, L., Bolgeo, T., D’Alessandro, A., Dal Molin, A. (2020). Long-term consequences in survivors of critical illness. Analysis of incidence and risk factors. Ann Ist Super Sanità, 56(1): 59-65.
Dowdy, D. W., Eid, M. P., Sedrakyan, A., Mendez-Tellez, P. A., Pronovost, P. J., Herridge M. S., Needham, D. M. (2005). Quality of life in adult survivors of critical illness: a systematic review. Intensive Care Med, 31(5), 611-20.
Dueñas, M., Ojeda, B., Salazar, A., Mico, J. A., Failde, I. (2016). A review of chronic pain impact on patients, their social environment and the health care system. J Pain Res, 9, 457–467.
Dureja, G. P., Jain, P. N., Shetty, N., Mandal, S. P., Prabhoo, R., Joshi, M., Goswami, S., Natarajan, K. B., Iyer, R., Tanna, D. D., Ghosh, P., Saxena, A., Kadhe, G., Phansalkar, A. A. (2014). Prevalence of chronic pain, impact on daily life, and treatment practices in India. Pain Pract, 14(2), E51-62.
Enright, A., & Goucke, R. (2016). The global burden of pain: The tip of the iceberg? Anesth Analg, 123, 529-30.
Fine, P. G. (2011). Long-term consequences of chronic pain: mounting evidence for pain as a neurological disease and parallels with other chronic disease states. Pain Med, 12(7), 996-1004.
Hauser, W., Bernardy, K., Uceyler, N., Sommer, C. (2009). Treatment of fibromyalgia syndrome with antidepressants: A meta-analysis. JAMA, 301(2), 198–209.
Jackson, T., Thomas, S., Stabile, V., Shotwell, M., Han, X., McQueen, K., et al. (2016). A systematic review and meta-analysis of the global burden of chronic pain without clear etiology in low- and middle-income countries: Trends in heterogeneous data and a proposal for new assessment methods. Anesth Analg, 123, 739-48.
Jacodic, H. K., Jacodic, K., & Podbregar, M. (2006). Long term outcome and quality of life of patients treated in a surgical intensive care: a comparison between sepsis and trauma. Crit Care, 10(5), R134.
Jones, G. T., Power, C., & Macfarlane, G. J. (2009). Adverse events in childhood and chronic widespread pain in adult life: results from the 1958 British Birth Cohort Study. Pain, 143, 92–6.
Langerud, A. K., Rustøen, T., Brunborg, C., Kongsgaard, U., Stubhaug, A. (2018). Prevalence, Location, and Characteristics of Chronic Pain in Intensive Care Survivors. Pain Manag Nurs, 19(4), 366-376.
Latina, R., Sansoni, J., D'Angelo, D., Di Biagio, E., De Marinis, M. G., Tarsitani, G. (2013). Etiology and prevalence of chronic pain in adults: a narrative review. Prof Inferm, 66(3), 151-8.
Lennihan, B. (2017). Homeopathy for Pain Management. Alternative and Complementary Therapies, 23(5), 176-183.
Lim, J., Choi, S., Lee, W. J., Jang, J. H., Moon, J. Y., Kim, Y. C., Kang, D. (2018). Cognitive-behavioral therapy for patients with chronic pain: Implications of gender differences in empathy. Medicine (Baltimore), 97(23), e10867.
Lipman, A. G. (2005). Pain as a human right: The 2004 global day against pain. J Pain Palliat Care Pharmacother, 19, 85-100.
Melotti., R. M., Samolsky-Dekel, B. G., Ricchi, E., Chiari, P., Di Giacinto, I., Carosi, F., Di Nino G. F. (2005). Pain prevalence and predictors among inpatients in a major Italian hospital. A baseline survey towards a pain free hospital. European Journal of Pain. 9, 485-95.
Nahin, R. L. (2015). Estimates of pain prevalence and severity in adults: United States, 2012. J Pain, 16, 769-80.
Nakamura, M., Nishiwaki, Y., Ushida, T., Toyama, Y. (2011). Prevalence and characteristics of chronic musculoskeletal pain in Japan. J Orthop Sci, 16(4), 424-32.
Nasir, D., Howard, J. E, Joshi, G. P., Hill, G. E. (2011). A survey of acute pain service structure and function in United States hospitals. Pain Res Treat, 2011, 934932.
Rossignol, M., Begaud, B., Engel, P., Avouac, B., Lert, F., Rouillon, F., Bénichou, J., Massol, J., Duru, G., Magnier, A. M., Guillemot, D., Grimaldi-Bensouda, L., Abenhaim, L.; EPI3-LA-SER group. (2012). Impact of physician preferences for homeopathic or conventional medicines on patients with musculoskeletal disorders: Results from the EP13-MSD cohort. Pharmacoepidemiol Drug Saf, 21, 1093–1101.
Sakakibara, T., Wang, Z., Paholpak, P., Kosuwon, W., Oo, M., Kasai, Y., et al. (2013). A comparison of chronic pain prevalence in Japan, Thailand, and Myanmar. Pain Physician, 16, 603-8.
Saxena, A. K., Jain, P. N., & Bhatnagar, S. (2018). The Prevalence of Chronic Pain among Adults in India. Indian J Palliat Care, 24(4), 472–477.
Smith, B. H., Elliott, A. M., Chambers, W. A., Smith, W. C., Hannaford, P. C., Penny, K. (2001). The impact of chronic pain in the community. Fam Pract, 18, 292–299.
Smith, B. H., Fors, E. A., Korwisi, B., Barke, A., Cameron, P., Colvin, L., Richardson, C., Rief, W., Treede, R. D.; IASP Taskforce for the Classification of Chronic Pain. (2019). The IASP classification of chronic pain for ICD-11: applicability in primary care. Pain, 160(1):83-87.
Vieira, E. B., Garcia, J. B., Silva, A. A., Araujo, R. L., Jansen, R. C., Bertrand, A. L. (2012). Chronic pain, associated factors, and impact on daily life: are there differences between the sexes? Cad Saude Public, 28, 1459–1467
Whynes, D. K., and the TOMBOLA Group. (2008). Correspondence between EQ-5D health state classifications and EQ VAS scores. Health and Quality of Life Outcomes, 6, 94.

Riferimenti

Andrasik, F., Grazzi, L., Usai, S., Bussone, G. (2007). Pharmacological treatment compared to behavioural treatment for juvenile tension-type headache: results at two-year follow-up. Neurol Sci, 28 Suppl 2, S235-8.

Battle, C. E., Lovett, S., & Hutchings, H. (2013). Chronic pain in survivors of critical illness: a retrospective analysis of incidence and risk factors. Crit Care, 29-17(3), R101.

Breivik, H., Collett, B., Ventafridda, V., Cohen, R., Gallacher, D. (2006). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. Eur J Pain, 10, 287-333.

Brennan, M. J., & Lieberman, J. A. (2009). Sleep disturbances in patients with chronic pain: Effectively managing opioid analgesia to improve outcomes. Curr Med Res Opin, 25(5), 1045–55.

Bonezzi, C., Nava, A., Barbieri, M., Bettaglio, R., De-martini, L., Miotti, D., Paulin, L. (2002). Validazione della versione italiana del Brief Pain Inventory nei pazienti con dolore cronico. Minerva Anestesiologica, 68(7-8), 607-11.

Bouhassira, D., Lantéri-Minet, M., Attal, N., Laurent, B., Touboul, C. (2008). Prevalence of chronic pain with neuropathic characteristics in the general population. Pain, 136, 380-7.

Butler, A. C., Chapman, J. E., Forman, E. M., Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev, 26, 17–31.

Cardenas, D. D., Bryce, T. N., Shem, K., Richards, J. S., Elhefni, H. (2004). Gender and minority differences in the pain experiences of people with spinal cord injury. Arch Phys Med Rehabil, 85, 1774–1781.

Damico, V., Cazzaniga, F., Murano, L., Ciceri, R., Nattino, G., Dal Molin, A. (2018). Impact of a Clinical Therapeutic Intervention on Pain Assessment, Management, and Nursing Practices in an Intensive Care Unit: A before-and-after Study. Pain Management Nursing, 19(3), 256-266.

Damico, V., Murano, L., Cazzaniga, F., Dal Molin, A. (2018). Pain prevalence, severity, assessment and management in hospitalized adult patients: a results of a multicenter cross sectional study. Ann Ist Super Sanità, 54(3), 194-200.

Damico, V., Murano, L., Manzoni, L., Riggio, M., Dal Molin, A. (2020). The effects of a clinical therapeutic intervention in pain assessment and management in surgical ICU patients: a before-and-after intervention study on pain intensity and use of analgesia. Prof Inferm, 73(2):106-115.

Demirel, G., Yilmaz, H., Gencosmanoglu, B., Kesiktas¸ N. (1998). Pain following spinal cord injury. Spinal Cord, 36, 25–28.

Demoro, G., Damico, V., Murano, L., Bolgeo, T., D’Alessandro, A., Dal Molin, A. (2020). Long-term consequences in survivors of critical illness. Analysis of incidence and risk factors. Ann Ist Super Sanità, 56(1): 59-65.

Dowdy, D. W., Eid, M. P., Sedrakyan, A., Mendez-Tellez, P. A., Pronovost, P. J., Herridge M. S., Needham, D. M. (2005). Quality of life in adult survivors of critical illness: a systematic review. Intensive Care Med, 31(5), 611-20.

Dueñas, M., Ojeda, B., Salazar, A., Mico, J. A., Failde, I. (2016). A review of chronic pain impact on patients, their social environment and the health care system. J Pain Res, 9, 457–467.

Dureja, G. P., Jain, P. N., Shetty, N., Mandal, S. P., Prabhoo, R., Joshi, M., Goswami, S., Natarajan, K. B., Iyer, R., Tanna, D. D., Ghosh, P., Saxena, A., Kadhe, G., Phansalkar, A. A. (2014). Prevalence of chronic pain, impact on daily life, and treatment practices in India. Pain Pract, 14(2), E51-62.

Enright, A., & Goucke, R. (2016). The global burden of pain: The tip of the iceberg? Anesth Analg, 123, 529-30.

Fine, P. G. (2011). Long-term consequences of chronic pain: mounting evidence for pain as a neurological disease and parallels with other chronic disease states. Pain Med, 12(7), 996-1004.

Hauser, W., Bernardy, K., Uceyler, N., Sommer, C. (2009). Treatment of fibromyalgia syndrome with antidepressants: A meta-analysis. JAMA, 301(2), 198–209.

Jackson, T., Thomas, S., Stabile, V., Shotwell, M., Han, X., McQueen, K., et al. (2016). A systematic review and meta-analysis of the global burden of chronic pain without clear etiology in low- and middle-income countries: Trends in heterogeneous data and a proposal for new assessment methods. Anesth Analg, 123, 739-48.

Jacodic, H. K., Jacodic, K., & Podbregar, M. (2006). Long term outcome and quality of life of patients treated in a surgical intensive care: a comparison between sepsis and trauma. Crit Care, 10(5), R134.

Jones, G. T., Power, C., & Macfarlane, G. J. (2009). Adverse events in childhood and chronic widespread pain in adult life: results from the 1958 British Birth Cohort Study. Pain, 143, 92–6.

Langerud, A. K., Rustøen, T., Brunborg, C., Kongsgaard, U., Stubhaug, A. (2018). Prevalence, Location, and Characteristics of Chronic Pain in Intensive Care Survivors. Pain Manag Nurs, 19(4), 366-376.

Latina, R., Sansoni, J., D'Angelo, D., Di Biagio, E., De Marinis, M. G., Tarsitani, G. (2013). Etiology and prevalence of chronic pain in adults: a narrative review. Prof Inferm, 66(3), 151-8.

Lennihan, B. (2017). Homeopathy for Pain Management. Alternative and Complementary Therapies, 23(5), 176-183.

Lim, J., Choi, S., Lee, W. J., Jang, J. H., Moon, J. Y., Kim, Y. C., Kang, D. (2018). Cognitive-behavioral therapy for patients with chronic pain: Implications of gender differences in empathy. Medicine (Baltimore), 97(23), e10867.

Lipman, A. G. (2005). Pain as a human right: The 2004 global day against pain. J Pain Palliat Care Pharmacother, 19, 85-100.

Melotti., R. M., Samolsky-Dekel, B. G., Ricchi, E., Chiari, P., Di Giacinto, I., Carosi, F., Di Nino G. F. (2005). Pain prevalence and predictors among inpatients in a major Italian hospital. A baseline survey towards a pain free hospital. European Journal of Pain. 9, 485-95.

Nahin, R. L. (2015). Estimates of pain prevalence and severity in adults: United States, 2012. J Pain, 16, 769-80.

Nakamura, M., Nishiwaki, Y., Ushida, T., Toyama, Y. (2011). Prevalence and characteristics of chronic musculoskeletal pain in Japan. J Orthop Sci, 16(4), 424-32.

Nasir, D., Howard, J. E, Joshi, G. P., Hill, G. E. (2011). A survey of acute pain service structure and function in United States hospitals. Pain Res Treat, 2011, 934932.

Rossignol, M., Begaud, B., Engel, P., Avouac, B., Lert, F., Rouillon, F., Bénichou, J., Massol, J., Duru, G., Magnier, A. M., Guillemot, D., Grimaldi-Bensouda, L., Abenhaim, L.; EPI3-LA-SER group. (2012). Impact of physician preferences for homeopathic or conventional medicines on patients with musculoskeletal disorders: Results from the EP13-MSD cohort. Pharmacoepidemiol Drug Saf, 21, 1093–1101.

Sakakibara, T., Wang, Z., Paholpak, P., Kosuwon, W., Oo, M., Kasai, Y., et al. (2013). A comparison of chronic pain prevalence in Japan, Thailand, and Myanmar. Pain Physician, 16, 603-8.

Saxena, A. K., Jain, P. N., & Bhatnagar, S. (2018). The Prevalence of Chronic Pain among Adults in India. Indian J Palliat Care, 24(4), 472–477.

Smith, B. H., Elliott, A. M., Chambers, W. A., Smith, W. C., Hannaford, P. C., Penny, K. (2001). The impact of chronic pain in the community. Fam Pract, 18, 292–299.

Smith, B. H., Fors, E. A., Korwisi, B., Barke, A., Cameron, P., Colvin, L., Richardson, C., Rief, W., Treede, R. D.; IASP Taskforce for the Classification of Chronic Pain. (2019). The IASP classification of chronic pain for ICD-11: applicability in primary care. Pain, 160(1):83-87.

Vieira, E. B., Garcia, J. B., Silva, A. A., Araujo, R. L., Jansen, R. C., Bertrand, A. L. (2012). Chronic pain, associated factors, and impact on daily life: are there differences between the sexes? Cad Saude Public, 28, 1459–1467

Whynes, D. K., and the TOMBOLA Group. (2008). Correspondence between EQ-5D health state classifications and EQ VAS scores. Health and Quality of Life Outcomes, 6, 94.

Prevalenza e caratteristiche di dolore cronico nei pazienti dimessi dalla Terapia Intensiva e analisi dell’impatto sulla vita quotidiana e sulle scelte di trattamento terapeutico

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