title: Health utilities in people with chronic pain using a population-level survey and linked health care administrative data.
abstract: Health utilities are a preference-based measure of health-related quality of life that facilitates comparison of disease burden across conditions. We estimated utilities using a population-based, matched sample of adolescents and adults with and without chronic pain, controlling for comorbidity. Ontarians aged ≥12 years with and without chronic pain were identified from the Canadian Community Health Survey (CCHS) 2000-2001 and 2009-2010 and linked to their provincial health care administrative data. Individuals with chronic pain were matched to those without using age, sex, survey year, and a propensity score for having chronic pain estimated from a rurality index, income quintile, and comorbidity. The Health Utilities Index Mark 3 instrument, included in the Canadian Community Health Survey, was used. Mean utilities were calculated for each group. Utility decrement for chronic pain was also calculated for each matched pair. A total of 65,246 responses were available for analysis. After matching, there were 12,146 matched pairs with and without pain. In the matched cohort, mean age was 54 years (SD 12); 61% were female. The matched cohort with chronic pain had a mean utility of 0.59 (95% confidence interval 0.58-0.59), and the decrement associated with chronic pain was 0.32 (95% confidence interval 0.31-0.32). Utilities in people with chronic pain were lower than, and decrements larger than, those seen with most other chronic diseases including heart disease, diabetes, and chronic obstructive pulmonary disease. These data will be useful to inform priorities and future strategies for the prevention and control of chronic pain.
authors.affiliation: Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
authors.forename: Mary-Ellen
authors.initials: ME
authors.lastname: Hogan
authors.affiliation: Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.|Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Anna
authors.initials: A
authors.lastname: Taddio
authors.affiliation: Department of Psychology, York University, Toronto, ON, Canada.
authors.forename: Joel
authors.initials: J
authors.lastname: Katz
authors.affiliation: Mount Sinai Hospital, Toronto, ON, Canada.|Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
authors.forename: Vibhuti
authors.initials: V
authors.lastname: Shah
authors.affiliation: Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto, ON, Canada.|Faculty of Medicine and Pharmacy, University of Toronto, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: Murray
authors.initials: M
authors.lastname: Krahn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002170:Canada / Q000453:epidemiology; D002648:Child; D059350:Chronic Pain / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D015331:Cohort Studies; D016208:Databases, Factual; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006298:Health Services Administration; D006305:Health Status Indicators; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D011788:Quality of Life; D055815:Young Adult