Original research
Comorbidities That Cause Pain and the Contributors to Pain in Individuals With Chronic Obstructive Pulmonary Disease

https://doi.org/10.1016/j.apmr.2016.10.016Get rights and content

Abstract

Objective

To determine comorbidities that cause pain and the potential contributors to pain in individuals with chronic obstructive pulmonary disease (COPD).

Design

Prospective cross-sectional survey study.

Setting

Pulmonary rehabilitation programs of 6 centers.

Participants

A convenience sample of individuals with COPD (N=137) who attended pulmonary rehabilitation programs. In total, 100 (73%) returned the survey packages. Of those responders, 96 participants (70%) were included in the analyses.

Interventions

Not applicable.

Main Outcome Measures

Pain was measured using the Brief Pain Inventory. The questionnaire used to obtain information about health conditions that might contribute to pain and a medication record asked, in lay terms, about comorbidities that cause pain. The health conditions that cause pain were then validated by health professionals. Demographics, fatigue, dyspnea, quality of life, and self-efficacy were also measured using questionnaires.

Results

Pain was reported in 71% (68/96) of participants. Low back pain was the most common location (41%). Arthritis (75%), back problems (47%), and muscle cramps (46%) were the most common comorbidities that caused pain. Lower self-efficacy, and renting rather than home ownership increased the likelihood of pain (P<.05). Pain severity and Brief Fatigue Inventory scores contributed to pain interference scores (P<.05).

Conclusions

Pain was highly prevalent in pulmonary rehabilitation program participants with COPD. The most common causes of pain were musculoskeletal conditions. Pain severity and higher levels of fatigue contributed to how pain interfered with daily aspects of living. The assessment and management of pain need to be addressed within the overall care of individuals with COPD.

Section snippets

Study protocol and participants

This was a cross-sectional survey study. It was approved by the Clinical Research Ethics Board of the University of British Columbia. All participants of this study provided written informed consent.

A convenience sample of individuals with COPD was recruited from pulmonary rehabilitation programs at 6 sites in Metro Vancouver and Okanagan regions of British Columbia, Canada, from January 2014 to May 2015. All eligible participants who attended pulmonary rehabilitation programs at the

Results

In total, 100 (73%) of 137 participants returned the survey packages. Of those responders, 4 participants were excluded (3 chose to withdraw from the study; 1 was a duplicate participant). As a result, 96 participants (70%) were included in this study. Demographics of participants are presented in table 1.

Discussion

This study is the first to describe the underlying contributors to pain in individuals with COPD who attend pulmonary rehabilitation programs. In this study, 71% of participants with COPD experienced significant pain, and the most common comorbidities that cause pain were arthritis, followed by back problems and muscle cramps. Individuals with COPD who had a lower self-efficacy, and who rented rather than owned their home were more likely to have pain. Lastly, both pain severity and total BFI

Conclusions

In conclusion, pain is very common in COPD and is primarily associated with musculoskeletal conditions and muscle cramps. The severities of pain and fatigue are primary contributors to how pain interferes with daily aspects of living. Many of the items of the pain interference scale are descriptors fundamental to health such as sleep and physical activity. Pain, together with more commonly reported symptoms of dyspnea and fatigue, might severely limit exercise and physical activity in

Supplier

  • a.

    SPSS version 22; IBM Corp.

Acknowledgments

We thank the pulmonary rehabilitation programs at the following centers for recruiting participants: Ridge Meadow Hospital, Maple Ridge; Vancouver General Hospital, Vancouver; St. Paul's Hospital, Vancouver; Lion's Gate Hospital, North Vancouver; Vernon Jubilee Hospital, Vernon; and iConnect Health Centre, New Westminster.

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    Supported by a research grant from Forest Laboratories, Inc (UBC funding no. F14-02226), by the University of British Columbia and British Columbia Lung Association, by Scholar Awards from the Michael Smith Foundation for Health Research, and by a Canadian Institutes of Health Research New Investigator Award. Forest Laboratories, Inc, had no involvement in the study design; the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

    Disclosures: J.A.G. reports financial relationships with Novartis Canada, Agartee Tech Inc, Boehringer Ingelheim, and Novartis Hellas, outside the submitted work. H.O.C. reports personal fees from Samsung, grants from Spiration Inc., outside the submitted work. The other authors have nothing to disclose.

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