Trajectories of pain predict disabilities affecting daily living in arthritis

James, Richard J.E.; Walsh, David A.; Ferguson, Eamonn

Abstract

Purpose: To examine the interplay between pain and disability in arthritis when adjusting for patient heterogeneity in pain progression. There is consistent evidence to suggest that people experience osteoarthritis heterogeneously, with subgroups of people having different trajectories of pain. However, at present it is unclear how these pain trajectories are related to functional disability. We ask the question: Do levels of disability track changes in pain across different pain trajectories?
Methods: Secondary analysis of a subset (n = 889) from a cohort of older English adults, representative of the general population (the English Longitudinal Study of Ageing). The relationship between pain and functional disability was compared in three domains of disability: mobility, activities of daily living and instrumental activities of daily living. These represent increasingly complex forms of self-care required for independent living. Data analysis compared the heterogeneous analysis of pain (different trajectories) and disability compared to treating pain as a simpler homogenous construct.
Results: On a population level, pain was significantly positively correlated with increased disability in all three domains, and the relationship remained stable over time. However, when heterogeneity was examined respondents whose pain improved did not show a corresponding improvement in disability in 2 domains (ADL and mobility).
Conclusions: These findings highlight how, for some people, alleviating pain, the main symptom of arthritis, might not prevent the persistence or progression of disability. Even when pain improves, further interventions that improve disability are likely to be required.

Citation

James, R. J., Walsh, D. A., & Ferguson, E. (2019). Trajectories of pain predict disabilities affecting daily living in arthritis. British Journal of Health Psychology, 24(3), 465-496. https://doi.org/10.1111/bjhp.12364

• Journal Article Type: Article
• Acceptance Date: Feb 27, 2019
• Online Publication Date: Apr 7, 2019
• Publication Date: Sep 1, 2019
• Deposit Date: Mar 15, 2019
• Publicly Available Date: Apr 15, 2019
• Journal: British Journal of Health Psychology
• Print ISSN: 1359-107X
• Electronic ISSN: 2044-8287
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 24
• Issue: 3
• Pages: 465-496
• DOI: https://doi.org/10.1111/bjhp.12364
• Keywords: Arthritis; pain; disability; activities of daily living; personalized medicine
• Public URL: https://nottingham-repository.worktribe.com/output/1655465
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/bjhp.12364
• Contract Date: Mar 15, 2019