title: United States National Pain Strategy for Population Research: Concepts, Definitions, and Pilot Data.
abstract: National Pain Strategy population research objectives include: estimating chronic pain prevalence, studying pain treatment with electronic health care data, and developing metrics to assess progress in reducing chronic pain impact. In this article, the National Pain Strategy Population Research Workgroup reviews concepts relevant to achieving these aims. High-impact chronic pain was defined as persistent pain with substantial restriction of life activities lasting 6 months or more. In pilot work, we tested a brief assessment of high-impact chronic pain, and used electronic health records data to describe pain-related health care. A mail survey of adult health plan enrollees (N = 770) reported that 14% had high-impact chronic pain. Relative to persons with lower-impact chronic pain, those with high-impact chronic pain were more often frequent users of health care for pain, reported lower quality of life, greater pain-related interference with activities, and more often reported pain at multiple anatomic locations. Analyses of health care data (N = 289,464) reported that pain patients had higher health care costs compared with others and that pain services were typically delivered in primary care. These results support the feasibility of developing data on chronic pain through national health interview surveys and large electronic health care databases.
  
  
  
  Pilot analyses supported the feasibility of brief chronic pain assessments suitable for national health surveys and use of electronic health care databases to develop data regarding trends in the delivery of pain treatments, costs, and effectiveness. These methods are relevant to achieving the aims of the US National Pain Strategy.
authors.affiliation: Group Health Research Institute, Seattle, Washington. Electronic address: vonkorff.m@ghc.org.
authors.forename: Michael
authors.initials: M
authors.lastname: Von Korff
authors.affiliation: Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Ann I
authors.initials: AI
authors.lastname: Scher
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Charles
authors.initials: C
authors.lastname: Helmick
authors.affiliation: University of Maryland School of Public Health, College Park, Maryland.
authors.forename: Olivia
authors.initials: O
authors.lastname: Carter-Pokras
authors.affiliation: Mayo Clinic College of Medicine, Phoenix, Arizona.
authors.forename: David W
authors.initials: DW
authors.lastname: Dodick
authors.affiliation: Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Joseph
authors.initials: J
authors.lastname: Goulet
authors.affiliation: University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Robin
authors.initials: R
authors.lastname: Hamill-Ruth
authors.affiliation: University of Washington School of Dentistry, Seattle, Washington.
authors.forename: Linda
authors.initials: L
authors.lastname: LeResche
authors.affiliation: National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
authors.forename: Linda
authors.initials: L
authors.lastname: Porter
authors.affiliation: Department of Psychiatry, St. Louis University School of Medicine, St. Louis, Missouri.
authors.forename: Raymond
authors.initials: R
authors.lastname: Tait
authors.affiliation: University of Washington School of Medicine, Seattle, Washington.
authors.forename: Gregory
authors.initials: G
authors.lastname: Terman
authors.affiliation: Chronic Pain Research Alliance, Milwaukee, Wisconsin.
authors.forename: Christin
authors.initials: C
authors.lastname: Veasley
authors.affiliation: Stanford University School of Medicine, Palo Alto, California.
authors.forename: Sean
authors.initials: S
authors.lastname: Mackey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000191:economics / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D016208:Databases, Factual; D057286:Electronic Health Records; D005240:Feasibility Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012107:Research Design; D011795:Surveys and Questionnaires; D009626:Terminology as Topic; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Chronic pain; electronic databases; epidemiology; health services research; prevalence