title: Self-reports of medication side effects and pain-related activity interference in patients with chronic pain: a longitudinal cohort study.
abstract: The primary purpose of this study was to examine the association between self-reports of medication side effects and pain-related activity interference in patients with chronic pain. The potential moderators of the association between reports of side effects and pain-related activity interference were also examined. A total of 111 patients with chronic musculoskeletal pain were asked to provide, once a month for a period of 6 months, self-reports of medication use and the presence of any perceived side effects (eg, nausea, dizziness, headaches) associated with their medications. At each of these time points, patients were also asked to provide self-reports of pain intensity, negative affect, and pain-related activity interference. Multilevel modeling analyses revealed that month-to-month increases in perceived medication side effects were associated with heightened pain-related activity interference (P < 0.05). Importantly, multilevel models revealed that perceived medication side effects were associated with heightened pain-related activity interference even after controlling for the influence of patient demographics, pain intensity, and negative affect. This study provides preliminary evidence that reports of medication side effects are associated with heightened pain-related activity interference in patients with chronic pain beyond the influence of other pain-relevant variables. The implications of our findings for clinical practice and the management of patients with chronic pain conditions are discussed.
authors.affiliation: Department of Anesthesiology, Harvard Medical School, Brigham and Women's Hospital Pain Management Center, Chestnut Hill, MA, USA Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA UPMC Pain Medicine, Departments of Anesthesiology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Marc O
authors.initials: MO
authors.lastname: Martel
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Finan
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Dolman
authors.forename: Subu
authors.initials: S
authors.lastname: Subramanian
authors.forename: Robert R
authors.initials: RR
authors.lastname: Edwards
authors.forename: Ajay D
authors.initials: AD
authors.lastname: Wasan
authors.forename: Robert N
authors.initials: RN
authors.lastname: Jamison
mesh_terms: D000328:Adult; D000700:Analgesics / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D059350:Chronic Pain / Q000188:drug therapy / Q000523:psychology / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015331:Cohort Studies; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D057566:Self Report; D019966:Substance-Related Disorders / Q000209:etiology
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal