Association of Chronic Pancreatitis Pain Features With Physical, Mental, and Social Health

Authors

Dhiraj Yadav
Robert L Askew
Tonya Palermo
Liang Li
Dana K Andersen
Minxing Chen
William E Fisher
Evan L Fogel
Christopher E Forsmark
Phil A Hart
Mohamed O Othman
Stephen J Pandol
Walter G Park
Mark D Topazian
Stephen K Van Den Eeden
Santhi Swaroop Vege
Yunlong Yang
Jose Serrano
Darwin L Conwell
Consortium for the Study of Chronic Pancreatitis, Diabetes
Pancreatic Cancer (CPDPC)

Publication Date

7-1-2023

Journal

Clinical Gastroenterology and Hepatology

DOI

10.1016/j.cgh.2022.09.026

PMID

36191836

PMCID

PMC10065964

PubMedCentral® Posted Date

7-1-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Humans, Longitudinal Studies, Chronic Pain, Pancreatitis, Chronic, Mental Health, Patient Reported Outcome Measures, Quality of Life

Abstract

BACKGROUND AND AIMS: Pain is a cardinal symptom of chronic pancreatitis (CP). Using Patient-Reported Outcomes Measurement Information System (PROMIS) measures, we characterized physical and mental health and symptom profiles of a well-defined cohort of individuals with CP and compared them with control subjects. Among patients with CP, we also examined associations between pain (intensity, temporal nature) and PROMIS symptom profiles and the prevalence of clinically significant psychological comorbidities.

METHODS: We analyzed baseline data in 488 CP patients and 254 control subjects enrolled in PROCEED (Prospective Evaluation of Chronic Pancreatitis for Epidemiologic and Translational Studies), an ongoing longitudinal cohort study. Participants completed the PROMIS-Global Health, which captures global physical and mental health, and the PROMIS-29 profile, which captures 7 symptom domains. Self-reported pain was categorized by severity (none, mild-moderate, severe) and temporal nature (none, intermittent, constant). Demographic and clinical data were obtained from the PROCEED database.

RESULTS: Pain was significantly associated with impairments in physical and mental health. Compared with participants with no pain, CP participants with severe pain (but not mild-moderate pain) had more decrements in each PROMIS domain in multivariable models (effect sizes, 2.54-7.03) and had a higher prevalence of clinically significant depression, anxiety, sleep disturbance, and physical disability (odds ratios, 2.11-4.74). Similar results were noted for constant pain (but not intermittent pain) for PROMIS domains (effect sizes, 4.08-10.37) and clinically significant depression, anxiety, sleep disturbance and physical disability (odds ratios, 2.80-5.38).

CONCLUSIONS: Severe and constant pain are major drivers for poor psychological and physical health in CP. Systematic evaluation and management of psychiatric comorbidities and sleep disturbance should be incorporated into routine management of patients with CP.

Comments

ClinicalTrials.gov number-NCT03099850.

Associated Data