Differences Among Veterans With Chronic Overlapping Pain Conditions and Other Chronic Pain: Baseline Results From the LAMP Pain Management Trial

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-09-15 DOI:10.1002/ejp.70125

Jenna L. Adamowicz, Alexis Grant, Collin Calvert, Daniel Elchert, Katherine Hadlandsmyth, Mary A. Driscoll, Stephanie L. Taylor, Kelli Allen, Brent C. Taylor, Diana J. Burgess

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引用次数: 0

Abstract

Background

Chronic overlapping pain conditions (COPCs) are a constellation of disorders posited to share an underlying pain mechanism (nociplastic pain). Unfortunately, individuals with COPCs are under-represented in clinical research. The current study aimed to determine COPC prevalence among participants enrolled in a pragmatic clinical trial and compare those with COPCs to those with non-COPCs across several domains.

Methods

Learning to Apply Mindfulness to Pain (LAMP) study baseline data of veterans with chronic pain (N = 811) were utilised. COPC diagnoses were determined using ICD-10 codes within electronic health records. Group differences across pain and functioning-related domains were compared with and without adjustment for age and gender.

Results

Among participants with COPCs (54%), most were diagnosed with only one COPC (74%). Chronic lower back pain (71%) and migraine (28%) were the most common. Participants with COPCs were younger and more likely to be female relative to those with non-COPCs. The COPC subset was also more likely to be diagnosed with PTSD, depressive disorders and sleep disorders (p < 0.05). Those with COPCs also reported greater pain severity and interference, more impaired health-related quality of life, greater pain catastrophising and lower pain self-efficacy than participants without COPCs (p < 0.05).

Conclusions

COPCs were common among a sample of veterans in a pragmatic clinical trial. Several baseline differences emerged indicating veterans with COPCs experience greater mental health concerns and endorse distinct pain characteristics and pain mediators. Future research is needed to further characterise this recently defined and under-represented group.

Significance Statement

Individuals with COPCs are medically complex, yet are understudied and underrepresented within pain trials research. COPCs, which predominantly impact women, are also understudied within U.S. veterans. Our findings highlight how veterans with COPCs are participating in clinical research even when interventions are not tailored to their unique characteristics. Our work also contributes to a nuanced understanding of this disease burden and is among the first to describe differences among veterans with COPCs and veterans with chronic pain but without COPCs.

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退伍军人慢性重叠疼痛和其他慢性疼痛的差异：来自LAMP疼痛管理试验的基线结果

慢性重叠疼痛状况（COPCs）是一系列疾病，被认为具有共同的潜在疼痛机制（伤害性疼痛）。不幸的是，患有COPCs的个体在临床研究中的代表性不足。当前的研究旨在确定COPC在临床试验参与者中的患病率，并在多个领域比较COPC患者和非COPC患者。方法采用慢性疼痛退伍军人（N = 811）的LAMP （Learning to Apply Mindfulness to Pain）研究基线数据。使用电子健康记录中的ICD-10代码确定COPC诊断。在调整和不调整年龄和性别的情况下，比较疼痛和功能相关领域的组间差异。结果在患有COPC的参与者中（54%），大多数被诊断为仅患有一种COPC（74%）。慢性腰痛（71%）和偏头痛（28%）是最常见的。与非COPCs患者相比，患有COPCs的参与者更年轻，更有可能是女性。COPC亚组也更容易被诊断为PTSD、抑郁症和睡眠障碍（p < 0.05）。与没有COPCs的参与者相比，患有COPCs的参与者还报告了更大的疼痛严重程度和干扰，更严重的健康相关生活质量受损，更大的疼痛灾难性和更低的疼痛自我效能感（p < 0.05）。结论在一项实用的临床试验中，COPCs在退伍军人样本中很常见。出现了一些基线差异，表明患有COPCs的退伍军人有更大的心理健康问题，并支持不同的疼痛特征和疼痛介质。未来的研究需要进一步描述这个最近被定义和代表性不足的群体。COPCs患者在医学上是复杂的，但在疼痛试验研究中研究不足，代表性不足。主要影响女性的COPCs在美国退伍军人中也没有得到充分研究。我们的研究结果强调了患有COPCs的退伍军人是如何参与临床研究的，即使干预措施没有针对他们的独特特征。我们的工作还有助于细致入微地了解这种疾病负担，并且是第一个描述患有COPCs的退伍军人和患有慢性疼痛但没有COPCs的退伍军人之间差异的研究之一。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.