Yang Yaoli1, Hollatz Trina2, Mukadam Zubin3, Laxova Anita4, Decker Catherine5, Braun Andrew T6. 1. Division of Pulmonary & Critical Care Medicine, University of Wisconsin. 600 Highland Ave, Madison, WI 53792 USA. Electronic address: Yyang2@uwhealth.org. 2. St. Luke's Pulmonary Medicine Associates. 920 East First Street, Suite P201, Duluth, MN 55805 USA. Electronic address: Trina.Hollatz@slhduluth.com. 3. Division of Pulmonary & Critical Care Medicine, Wayne State University, 3990 John R St Suite-3 Hudson, Detroit, MI 48201 USA. Electronic address: zmukadam@med.wayne.edu. 4. Cystic Fibrosis Clinical Trials Research Group, University of Wisconsin. K4/948 CSC, 600 Highland Ave, Madison, WI 53792 USA. Electronic address: alaxova@pediatrics.wisc.edu. 5. Division of Pulmonary and Critical Care Medicine, University of Wisconsin. 600 Highland Ave, Madison, WI 53792 USA. Electronic address: cdecker@uwhealth.org. 6. Division of Pulmonary & Critical Care Medicine, University of Wisconsin. 600 Highland Ave, Madison, WI 53792 USA. Electronic address: atbraun@medicine.wisc.edu.
Abstract
BACKGROUND: The high incidence and prevalence of chronic pain in patients with cystic fibrosis (CF) is well documented. However, there is limited data on chronic pain management in this population. METHODS: We designed a questionnaire examining care team members' views on the prevalence and characteristics of pain, pain management, and opioid use. The questionnaire was distributed to accredited programs throughout the US via a CF Foundation (CFF) email list-serve. RESULTS: Responses came from 52 adult core or affiliated centers (Adult Responders - AR), 36 pediatric core or affiliated centers (Pediatric Responders - PR), and 9 were from combined programs. AR perceive more patients having chronic pain compared to PR. Furthermore, 40% of the AR said that > 50% of those with chronic pain also have comorbid depression or anxiety. 61% of PR ranked sinus/headache symptoms as the most common while AR ranked chest wall as the most frequent site (58%). While most centers (83%) report that pain management in patients with CF is a very important or important issue, 50% of AR feel uncomfortable or only slightly comfortable in prescribing opioids. 44% report that CF providers are currently responsible for this task. CONCLUSIONS: Chronic pain is common in adult patients with CF and management presents a formidable challenge to providers. The development of guidelines and/or collaboration with pain specialists will likely benefit both patients and providers.
BACKGROUND: The high incidence and prevalence of chronic pain in patients with cystic fibrosis (CF) is well documented. However, there is limited data on chronic pain management in this population. METHODS: We designed a questionnaire examining care team members' views on the prevalence and characteristics of pain, pain management, and opioid use. The questionnaire was distributed to accredited programs throughout the US via a CF Foundation (CFF) email list-serve. RESULTS: Responses came from 52 adult core or affiliated centers (Adult Responders - AR), 36 pediatric core or affiliated centers (Pediatric Responders - PR), and 9 were from combined programs. AR perceive more patients having chronic pain compared to PR. Furthermore, 40% of the AR said that > 50% of those with chronic pain also have comorbid depression or anxiety. 61% of PR ranked sinus/headache symptoms as the most common while AR ranked chest wall as the most frequent site (58%). While most centers (83%) report that pain management in patients with CF is a very important or important issue, 50% of AR feel uncomfortable or only slightly comfortable in prescribing opioids. 44% report that CF providers are currently responsible for this task. CONCLUSIONS: Chronic pain is common in adult patients with CF and management presents a formidable challenge to providers. The development of guidelines and/or collaboration with pain specialists will likely benefit both patients and providers.