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Impact of chronic pain on health care seeking, self care, and medication: results from a population-based Swedish study
Kristianstad University, Department of Health Sciences.ORCID iD: 0000-0001-9283-5096
Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
Sektion för reumatologi, Medicinkliniken, Centralsjukhuset Kristianstad.
Avdelningen för Samhällsmedicinska vetenskaper Lund/Dalby, Lunds Universitet.
1999 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 53, no 8, 503-509 p.Article in journal (Refereed) Published
Abstract [en]

STUDY OBJECTIVE: To explore individual and social factors that could predict health care utilisation and medication among people with chronic pain in an unselected population. DESIGN: A mailed survey with questions about pain and mental symptoms, disability, self care action, visits to health care providers, and medication. SETTING: General populations in two Swedish primary health care (PHC) districts. Medical care was given in a state health system. PARTICIPANTS: A random sample (from the population register) of 15% of the population aged 25-74 (n = 1806). MAIN RESULTS: Among people reporting chronic pain 45.7% (compared with 29.8 of non-chronic pain persons, p < 0.05) consulted a physician and 7.2% (compared with 1.2%, p < 0.05) a physiotherapist during three months. Primary health care was the most frequent care provider. High pain intensity, aging, depression, ethnicity, and socioeconomic level had the greatest impact on physician consultations. Alternative care, used by 5.9%, was associated with high pain intensity and self care. Use of self care was influenced by high pain intensity, regular physical activity, and ethnicity. Alternative care and self care did not imply lower use of conventional health care. Women reporting chronic pain consumed more analgesics and sedatives than corresponding men. Besides female gender, high pain intensity, insomnia, physician consultation, social network, and self care action helped to explain medication with analgesics. Use of herbal remedies and ointments correlated to self care action, visit to an alternative therapist, high pain intensity, and socioeconomic level. CONCLUSIONS: The presence of chronic pain has an impressive impact on primary health care and medication. Various therapeutic actions are common and are partly overlapping. The use of health care among people with chronic pain depends above all on pain perception and intensity of pain but is also affected by ethnicity, age, socioeconomic level, and depressive symptoms. Among people with chronic pain use of analgesics is common in contrast with other types of pain relief (acupuncture, physiotherapy) suitable for treating chronic pain symptoms.

Place, publisher, year, edition, pages
1999. Vol. 53, no 8, 503-509 p.
Keyword [en]
chronic pain, health care, alternative care, medication
National Category
Family Medicine Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hkr:diva-894ISI: 000081705800013PubMedID: 10562870OAI: oai:DiVA.org:hkr-894DiVA: diva2:222686
Available from: 2009-06-10 Created: 2009-06-09 Last updated: 2014-01-15Bibliographically approved
In thesis
1. Chronic pain: epidemiological studies in a general population
Open this publication in new window or tab >>Chronic pain: epidemiological studies in a general population
1998 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim was to study the epidemiology of chronic pain (> 3 months duration) and factors associated to pain prevalence, prognosis, health care and medication in a general population. A cross-sectional mailed survey to a random population sample (n = 1806) was followed by a clinical examination and a prospective study of three selected groups. Pain related diagnoses from primary health care was monitored and compared with pain prevalence. The most important findings were: - a high total prevalence of chronic pain, 55.2%, without gender difference but varying by age and socioeconomic level. About one fourth (12.8%) reported high pain intensity and functional impairments. Women experienced pain at more locations and with higher intensity. - in a multivariate analysis increasing age, female gender, low education, high work strain, depression and insomnia were associated with chronic pain. - widespread pain showed a worse 2- year prognosis compared with neck shoulder pain. - musculoskeletal location of pain dominated, myalgia and myofascial pain being the most common symptom descriptions. - co-morbidity with chronic pain was common. More hypertensives and an increased level of serum uric acid associated to widepread pain indicated possible metabolic connections to pain. - smoking (current and previous) was associated with low-back and widespread pain. - chronic pain had a substantial influence of primary health care-seeking and medication; high pain intensity being the most important predictor of care and medication. - pain related diagnoses in primary health care increased between 1987 and 1996. Chronic pain, mainly with musculoskeletal location, is a community health problem. A multi-factorial approach in prevention and treatment on the basis of present knowledge is necessary.

Place, publisher, year, edition, pages
Lund: Univ., 1998. 142 p.
Keyword
chronic pain, epidemiology, health care
National Category
Public Health, Global Health, Social Medicine and Epidemiology Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-968 (URN)91-628-2935-1 (ISBN)
Public defence
1998-04-29, Segerfalksalen, Wallenberg Neuro Centre, Lunds Universitet, Lund, 09:00 (Swedish)
Opponent
Supervisors
Note

ISRN LUMEDW/MECH-1025-SE

Available from: 2009-06-24 Created: 2009-06-23 Last updated: 2014-01-15Bibliographically approved

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