TY - JOUR
T1 - Association of Chronic Pancreatitis Pain Features With Physical, Mental, and Social Health
AU - Consortium for the Study of Chronic Pancreatitis, Diabetes
AU - Pancreatic Cancer (CPDPC)
AU - Yadav, Dhiraj
AU - Askew, Robert L.
AU - Palermo, Tonya
AU - Li, Liang
AU - Andersen, Dana K.
AU - Chen, Minxing
AU - Fisher, William E.
AU - Fogel, Evan L.
AU - Forsmark, Christopher E.
AU - Hart, Phil A.
AU - Othman, Mohamed O.
AU - Pandol, Stephen J.
AU - Park, Walter G.
AU - Topazian, Mark D.
AU - Van Den Eeden, Stephen K.
AU - Vege, Santhi Swaroop
AU - Yang, Yunlong
AU - Serrano, Jose
AU - Conwell, Darwin L.
N1 - Publisher Copyright:
© 2023 AGA Institute
PY - 2023/7
Y1 - 2023/7
N2 - 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. (ClinicalTrials.gov, Number: NCT03099850).
AB - 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. (ClinicalTrials.gov, Number: NCT03099850).
KW - Anxiety
KW - Depression
KW - PROMIS
KW - Pancreas
KW - Pancreatitis
KW - Sleep disturbance
UR - http://www.scopus.com/inward/record.url?scp=85144450900&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85144450900&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2022.09.026
DO - 10.1016/j.cgh.2022.09.026
M3 - Article
C2 - 36191836
AN - SCOPUS:85144450900
SN - 1542-3565
VL - 21
SP - 1781-1791.e4
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 7
ER -