General and disease-specific pain trajectories as predictors of social and political outcomes in arthritis and cancer

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

Abstract

Background:
While the heterogeniety of pain progression has been studied in chronic diseases, it is unclear the extent to which patterns of pain progression among people in general as well as across different diseases impacts on social, civic and political engagement. We explore these issues for the first time.
Methods:
Using data from the English Longitudinal Study of Ageing, latent class growth models were used to estimate trajectories of self-reported pain in the entire cohort, and within subsamples reporting diagnoses of arthritis and cancer. These were compared at baseline on physical health (e.g., BMI, smoking) and over time on social, civic and political engagement.

Results:
Very similar four trajectory models fit the whole sample and arthritis subsamples, whereas a three trajectory model fit the cancer subsample. All samples had a modal group experiencing minimal chronic pain, and a group with high chronic pain that showed slight regression (more pronounced in cancer). Biometric indices were more predictive of the most painful trajectory in arthritis than cancer. In both samples the group experiencing the most pain at baseline reported impairments in social, civic and political engagement.

Conclusions:
The impact of pain differs between individuals and between diseases. Indicators of physical and psychological health differently predicted membership of the trajectories most affected by pain. These trajectories were associated with differences in engagement with social and civic life, which in turn was associated with poorer health and well-being.

Citation

James, R. J. E., Walsh, D. A., & Ferguson, E. (2018). General and disease-specific pain trajectories as predictors of social and political outcomes in arthritis and cancer. BMC Medicine, 16, Article 51. https://doi.org/10.1186/s12916-018-1031-9

• Journal Article Type: Article
• Acceptance Date: Feb 28, 2018
• Online Publication Date: Apr 9, 2018
• Publication Date: 2018-12
• Deposit Date: Mar 9, 2018
• Publicly Available Date: Apr 9, 2018
• Journal: BMC Medicine
• Electronic ISSN: 1741-7015
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 16
• Article Number: 51
• DOI: https://doi.org/10.1186/s12916-018-1031-9
• Keywords: Pain; arthritis; cancer; social engagement; voting; longitudinal
• Public URL: https://nottingham-repository.worktribe.com/output/924191
• Publisher URL: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1031-9
• Related Public URLs: https://bmcmedicine.biomedcentral.com/
• Additional Information: Received: 18 September 2017; Accepted: 28 February 2018; First Online: 9 April 2018; : Ethical approval was obtained for the data collection at all waves from the National Health Service (NHS) Research Committees service. This analysis was a secondary analysis of the anonymised survey data.; : Not applicable.; : All authors received grant funding from Arthritis Research UK. Eamonn Ferguson and David Walsh have previously received grant funding from Pfizer (relating to pain phenotypes in rheumatoid arthritis), outside of the submitted work.; : Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.