TY - JOUR
T1 - Investigating pain in heart failure patients
T2 - The pain assessment, incidence, and nature in heart failure (PAIN-HF) study
AU - Goodlin, Sarah J.
AU - Wingate, Sue
AU - Albert, Nancy M.
AU - Pressler, Susan J.
AU - Houser, Janet
AU - Kwon, Jennifer
AU - Chiong, Jun
AU - Storey, C. Porter
AU - Quill, Timothy
AU - Teerlink, John R.
PY - 2012/10
Y1 - 2012/10
N2 - Background: Patients with advanced heart failure (HF) have high rates of pain and other symptoms that diminish quality of life. We know little about the characteristics and correlates of pain in patients with advanced HF. Methods and Results: We identified pain prevalence, location, character, severity, frequency, and correlates in 347 outpatients with advanced HF enrolled from hospices and clinics. We evaluated the correlation of pain with HF-related quality of life, mortality, symptoms and health problems, and current treatments for pain. Pain at any site was reported by 293 patients (84.4%), and 138 (39.5%) reported pain at more than one site. The most common site of pain was the legs below the knees (32.3% of subjects). Pain interfered with activity for 70% of patients. Pain was "severe" or "very severe" for 28.6% of subjects with chest pain, and for 38.9% of those with other sites of pain. The only medication reported to provide pain relief was opioids, prescribed for 34.1% of subjects (P =.001). The strongest predictors of pain were degenerative joint disease (DJD) (odds ratio [OR] 14.95, 95% confidence interval [CI] 3.9-56.0; P <.001), other arthritis (OR 2.8, 95% CI 1.20-6.62; P =.017), shortness of breath (OR 3.27, 95% CI 1.47-7.28; P =.004), and angina pectoris (OR 3.38, 95% CI 1.30-8.81; P =.013). Conclusions: Pain occurred at multiple sites in patients with advanced HF. Pain correlated with DJD or other arthritis, shortness of breath, and angina. Only opioid analgesics provided relief of pain. Future research should evaluate the etiology of and interventions to manage pain in patients with HF.
AB - Background: Patients with advanced heart failure (HF) have high rates of pain and other symptoms that diminish quality of life. We know little about the characteristics and correlates of pain in patients with advanced HF. Methods and Results: We identified pain prevalence, location, character, severity, frequency, and correlates in 347 outpatients with advanced HF enrolled from hospices and clinics. We evaluated the correlation of pain with HF-related quality of life, mortality, symptoms and health problems, and current treatments for pain. Pain at any site was reported by 293 patients (84.4%), and 138 (39.5%) reported pain at more than one site. The most common site of pain was the legs below the knees (32.3% of subjects). Pain interfered with activity for 70% of patients. Pain was "severe" or "very severe" for 28.6% of subjects with chest pain, and for 38.9% of those with other sites of pain. The only medication reported to provide pain relief was opioids, prescribed for 34.1% of subjects (P =.001). The strongest predictors of pain were degenerative joint disease (DJD) (odds ratio [OR] 14.95, 95% confidence interval [CI] 3.9-56.0; P <.001), other arthritis (OR 2.8, 95% CI 1.20-6.62; P =.017), shortness of breath (OR 3.27, 95% CI 1.47-7.28; P =.004), and angina pectoris (OR 3.38, 95% CI 1.30-8.81; P =.013). Conclusions: Pain occurred at multiple sites in patients with advanced HF. Pain correlated with DJD or other arthritis, shortness of breath, and angina. Only opioid analgesics provided relief of pain. Future research should evaluate the etiology of and interventions to manage pain in patients with HF.
KW - Heart failure
KW - arthritis shortness of breath
KW - opioids
KW - pain
KW - symptoms
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U2 - 10.1016/j.cardfail.2012.07.007
DO - 10.1016/j.cardfail.2012.07.007
M3 - Article
C2 - 23040113
AN - SCOPUS:84867201246
SN - 1071-9164
VL - 18
SP - 776
EP - 783
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 10
ER -