K M Fiest1, J D Fisk2, S B Patten3, H Tremlett4, C Wolfson5, S Warren6, K A McKay7, L Berrigan8, R A Marrie9. 1. Department of Internal Medicine, College of Medicine, Faculty of Health Sciences, University of Manitoba, 820 Sherbrook Street, Winnipeg, Canada R3A1R9. 2. Departments of Psychiatry, Medicine, Psychology & Neuroscience, Dalhousie University, 6299 South Street, Halifax, Canada B3H4R2. 3. Departments of Psychiatry & Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, Canada T2N4Z6. 4. Division of Neurology, Faculty of Medicine, University of British Columbia, 2329 West Mall, Vancouver, Canada V6T1Z4. 5. Departments of Epidemiology & Biostatistics, Occupational Health, & Medicine, McGill University, 1020 Pine Avenue West, Montreal, Canada H3A 1A2. 6. Faculty of Rehabilitation Medicine, University of Alberta, 116 Street & 85 Avenue, Edmonton, Canada T6G2R3. 7. Department of Experimental Medicine, University of British Columbia, 2329 West Mall, Vancouver, Canada V6T1Z4. 8. Department of Psychology, St. Francis Xavier University, Antigonish, Canada B0H1X0. 9. Department of Internal Medicine, College of Medicine, Faculty of Health Sciences, University of Manitoba, 820 Sherbrook Street, Winnipeg, Canada R3A1R9; Department of Community Health Sciences, College of Medicine, University of Manitoba, 820 Sherbrook Street, Winnipeg, Canada R3A1R9. Electronic address: rmarrie@hsc.mb.ca.
Abstract
BACKGROUND: Comorbidities are common in multiple sclerosis (MS). The high prevalence of pain in MS is well-established but the influence of comorbidities on pain, specifically, pain-related interference in activity is not. OBJECTIVE: To examine the relationship between comorbidity and pain in MS. METHODS: We recruited 949 consecutive patients with definite MS from four Canadian centres. Participants completed the Health Utilities Index (HUI-Mark III) and a validated comorbidity questionnaire at 3 visits over 2 years. The HUI's pain scale was dichotomized into two groups: those with/without pain that disrupts normal activities. We used logistic regression to assess the association of pain with each comorbidity individually at baseline and over time. RESULTS: The incidence of disruptive pain over two years was 31.1 per 100 persons. Fibromyalgia, rheumatoid arthritis, irritable bowel syndrome, migraine, chronic lung disease, depression, anxiety, hypertension, and hypercholesterolemia were associated with disruptive pain (p<0.006). Individual-level effects on the presence of worsening pain were seen for chronic obstructive pulmonary disease (odds ratio [OR]: 1.50 95% CI: 1.08-2.09), anxiety (OR: 1.49 95% CI: 1.07-2.08), and autoimmune thyroid disease (OR: 1.40 95% CI: 1.00-1.97). CONCLUSION: Comorbidity is associated with pain in persons with MS. Closer examination of these associations may provide guidance for better management of this disabling symptom in MS.
BACKGROUND: Comorbidities are common in multiple sclerosis (MS). The high prevalence of pain in MS is well-established but the influence of comorbidities on pain, specifically, pain-related interference in activity is not. OBJECTIVE: To examine the relationship between comorbidity and pain in MS. METHODS: We recruited 949 consecutive patients with definite MS from four Canadian centres. Participants completed the Health Utilities Index (HUI-Mark III) and a validated comorbidity questionnaire at 3 visits over 2 years. The HUI's pain scale was dichotomized into two groups: those with/without pain that disrupts normal activities. We used logistic regression to assess the association of pain with each comorbidity individually at baseline and over time. RESULTS: The incidence of disruptive pain over two years was 31.1 per 100 persons. Fibromyalgia, rheumatoid arthritis, irritable bowel syndrome, migraine, chronic lung disease, depression, anxiety, hypertension, and hypercholesterolemia were associated with disruptive pain (p<0.006). Individual-level effects on the presence of worsening pain were seen for chronic obstructive pulmonary disease (odds ratio [OR]: 1.50 95% CI: 1.08-2.09), anxiety (OR: 1.49 95% CI: 1.07-2.08), and autoimmune thyroid disease (OR: 1.40 95% CI: 1.00-1.97). CONCLUSION: Comorbidity is associated with pain in persons with MS. Closer examination of these associations may provide guidance for better management of this disabling symptom in MS.
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Authors: Ruth Ann Marrie; Lesley Graff; John R Walker; John D Fisk; Scott B Patten; Carol A Hitchon; Lisa M Lix; James Bolton; Jitender Sareen; Alan Katz; Lindsay I Berrigan; James J Marriott; Alexander Singer; Renée El-Gabalawy; Christine A Peschken; Ryan Zarychanski; Charles N Bernstein Journal: JMIR Res Protoc Date: 2018-01-17
Authors: Dawn M Ehde; Kevin N Alschuler; Melissa A Day; Marcia A Ciol; Makena L Kaylor; Jennifer K Altman; Mark P Jensen Journal: Trials Date: 2019-12-27 Impact factor: 2.279