Self-management of chronic pain: a population-based study.
While effective self-management of chronic pain is important, clinic-based studies exclude the more typical pattern of self-management that occurs in the community, often without reference to health professionals. We examined specific hypotheses about the use of self-management strategies in a population-based study of chronic pain subjects. Data came from an Australian population-based random digit dialling computer-assisted telephone survey and included 474 adults aged 18 or over with chronic pain (response rate 73.4%). Passive strategies were more often reported than active ones: passive strategies such as taking medication (47%), resting (31.5%), and using hot/cold packs (23.4%) were most commonly reported, while the most commonly reported active strategy was exercising (25.8%). Only 33.5% of those who used active behavioural and/or cognitive strategies used them exclusively, while 67.7% of those who used passive behavioural and/or conventional medical strategies did so exclusively. Self-management strategies were associated with both pain-related disability and use of health services in multiple logistic regression models. Using passive strategies increased the likelihood of having high levels of pain-related disability (adjusted OR 2.59) and more pain-related health care visits (adjusted OR 2.9); using active strategies substantially reduced the likelihood of having high levels of pain-related disability (adjusted OR 0.2). In conclusion, we have shown in a population-based study that clinical findings regarding self-management strategies apply to the broader population and advocate that more attention be given to community-based strategies for improving awareness and uptake of active self-management strategies for chronic pain.
Blyth
Fiona M
FM
Pain Management and Research Institute, University of Sydney, Royal North Shore Hospital, St Leonards, NSW 2065, Australia Department of Rheumatology, University of Sydney, Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
March
Lyn M
LM
Nicholas
Michael K
MK
Cousins
Michael J
MJ
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002593:Cetrimonium Compounds; D002908:Chronic Disease; D003071:Cognition / Q000502:physiology; D003710:Demography; D004185:Disability Evaluation; D006233:Persons with Disabilities; D004338:Drug Combinations; D005260:Female; D019538:Health Care Surveys; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009226:Myristates; D009539:Nicotinic Acids; D016017:Odds Ratio; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012648:Self Care; D012841:Simethicone; D013229:Stearic Acids; D011795:Surveys and Questionnaires
D002593:Cetrimonium Compounds; D004338:Drug Combinations; D009226:Myristates; D009539:Nicotinic Acids; D013229:Stearic Acids; C058060:Prevasore; D012841:Simethicone