Sex Differences in Characteristics of Smokers with Chronic Pain Undergoing Multidisciplinary Pain Rehabilitation
Sex Differences in Characteristics of Smokers with Chronic Pain Undergoing Multidisciplinary Pain Rehabilitation
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DOI：
10.1111/j.1526-4637.2009.00702.x
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发表时间：
2009-11-01
期刊：
影响因子：
3.1
通讯作者：
Warner, David O.
中科院分区：
文献类型：
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作者：
Hooten, W. Michael;Townsend, Cynthia O.;Warner, David O.
Objective.本研究的主要目的是确定性别的影响，以及性别和吸烟状态之间的相互作用对接受多学科疼痛治疗的患者的直接治疗结果。一个回顾性的、重复的测量设计。三级转诊医疗中心的多学科疼痛康复中心。该队列（N = 1，241）包括928名女性和313名男性，其中313名为当前吸烟者，294名为既往吸烟者，634名为从不吸烟者，从2003年9月至2007年2月连续入院。为期3周的门诊多学科疼痛康复计划。结果测量。在入院和出院时进行多维度疼痛量表、简明健康状况问卷、流行病学中心抑郁量表、疼痛焦虑症状量表和疼痛灾难化量表。与男性相比，女性抑郁症状的改善显著更大（P = 0.023）。吸烟者在抑郁（P = 0.039）、疼痛灾难化（P = 0.010）和焦虑（P = 0.037）方面的改善明显大于既往吸烟者和从不吸烟者。按性别和吸烟状态的治疗之间未观察到显著的相互作用效应。在每日吗啡当量剂量（mg/d）下，男性吸烟者与女性吸烟者相比，在项目入院时消耗了更多的阿片类药物（P <0. 001）。吸烟状态对多学科疼痛治疗的即时治疗结果的影响不受性别的影响。然而，女性在抑郁症方面的改善明显大于男性，男性吸烟者在入院时摄入的阿片类药物量明显大于女性吸烟者。
Objective. The primary aim of this study was to determine the influence of sex and the interactions between sex and smoking status on the immediate treatment outcomes of patients undergoing multidisciplinary pain treatment.Design. A retrospective, repeated measures design.Setting. Multidisciplinary pain rehabilitation center at a tertiary referral medical center.Patients. The cohort (N = 1,241) included 928 women and 313 men of whom 313 were current smokers, 294 were former smokers and 634 were never smokers consecutively admitted from September 2003 through February 2007.Interventions. A 3-week outpatient multidisciplinary pain rehabilitation program.Outcome Measures. The Multidimensional Pain Inventory, Short Form-36 Health Status Questionnaire, Center for Epidemiologic Studies-Depression scale, Pain Anxiety Symptom Scale, and Pain Catastrophizing Scale were administered at admission and dismissal.Results. Women experienced significantly greater improvement in depressive symptoms compared with men (P = 0.023). Smokers experienced significantly greater improvements in depression (P = 0.039), pain catastrophizing (P = 0.010), and anxiety (P = 0.037) compared with former and never smokers. No significant interaction effects between treatment by sex by smoking status were observed. A significant sex by smoking status interaction was observed for daily morphine equivalent dose (mg/d) where male smokers consumed greater quantities of opioids compared with female smokers at program admission (P < 0.001).Conclusions. The effects of smoking status on the immediate treatment outcomes of multidisciplinary pain treatment are not modified by sex. However, women experienced significantly greater improvement in depression than men and male smokers consumed significantly greater quantities of opioids compared with female smokers at admission.