Daily pain variations among patients with hand, hip, and knee osteoarthritis
Daily pain variations among patients with hand, hip, and knee osteoarthritis
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DOI：
10.1016/j.joca.2009.03.021
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发表时间：
2009-10-01
影响因子：
7
通讯作者：
Keefe, F. J.
中科院分区：
文献类型：
--
作者：
Allen, K. D.;Coffman, C. J.;Keefe, F. J.
目的：本研究探讨了一天内骨关节炎（OA）相关的疼痛模式和相关的patient characteristics.Methods：参与者与医生诊断和自我报告的症状手（N = 40），髋关节（N = 32），膝关节（N = 85）OA记录疼痛使用掌上电脑在一个工作日和一个周末的一天，评级开始后立即醒来，然后大约每2小时以下。疼痛在滑动视觉模拟量表上进行评级，隐藏编码为1-100。多变量线性混合模型检查了患者人口统计学特征、招募地点（达勒姆VA医学中心vs杜克大学医学中心）、关节部位、体重指数和止痛药使用情况以及日内疼痛范围（最大减去最小疼痛评级）和疼痛评级的曲线下面积（AUC），其合并了所有疼痛测量的幅度。疼痛模式在个体之间差异很大。平均、最大和最小工作日疼痛评分的样本均值分别为35.3、54.4和17.9。平均疼痛范围为36.4，平均疼痛AUC为564.3（可能范围：16-1600）。周末的疼痛评分相似。在多变量混合模型中，膝关节和髋关节OA与比手部OA更大的日内疼痛范围相关。只有VA登记网站与一个显着更大的疼痛AUC.Conclusion：有大量的OA相关的疼痛在一天之内的范围。疼痛范围和总体日内幅度根据患者特征而变化。患者一天内疼痛模式的记录可用于临床治疗，以定制药物使用时间和行为策略的建议。由Elsevier Ltd代表国际骨关节炎研究协会出版。
Objective: This study examined within-day osteoarthritis (OA)-related pain patterns and associated patient characteristics.Methods: Participants with physician diagnoses and self-reported symptoms of hand (N = 40), hip (N = 32), and knee (N = 85) OA recorded pain using a handheld computer on one weekday and one weekend day, with ratings beginning immediately after waking, then approximately every 2 h following. Pain was rated on a sliding visual analog scale with hidden coding of 1-100. Multivariable linear mixed models examined associations of patient demographic characteristics, enrollment site (Durham VA Medical Center vs Duke University Medical Center), joint site, body mass index, and pain medication use with within-day pain range (maximum minus minimum pain rating) and area under the curve (AUC) of pain ratings, which incorporates the magnitude of all pain measurements.Results: Pain patterns differed substantially across individuals. The sample means of the average, maximum, and minimum weekday pain scores were 35.3, 54.4, and 17.9, respectively. The mean pain range was 36.4, and the mean pain AUC was 564.3 (possible range: 16-1600). Pain scores were similar on weekends. In multivariable mixed models, both knee and hip OA were associated with a greater within-day pain range than hand OA. Only VA enrollment site was associated with a significantly greater pain AUC.Conclusion: There is substantial within-day range in OA-related pain. Both pain range and overall within-day magnitude vary according to patient characteristics. Patients' records of within-day pain patterns could be used in clinical encounters to tailor recommendations for the timing of medication use and behavioral strategies. Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International.