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Health Services Research & Development

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2006 HSR&D National Meeting Abstract


3047 — The Burden of Chronic Pain among VA Patients

Author List:
Butchart AT (Center for Practice Management and Outcomes Research)
Kerr EA (Center for Practice Management and Outcomes Research)
Heisler ME (Center for Practice Management and Outcomes Research)
Piette JD (Center for Practice Management and Outcomes Research)
Krein SL (Center for Practice Management and Outcomes Research)

Objectives:
To determine the prevalence of chronic pain in VHA primary care patients and examine the burden of chronic pain among patients with other chronic illnesses.

Methods:
Three random samples of VHA primary care patients were mailed surveys: 300 patients with chronic heart failure (CHF), 300 with diabetes, and 300 general primary care patients. All patients were asked about their health status and disability and whether they had pain present most of the time for 6 months or more during the past year. Patients who reported chronic pain were further queried about the influence of pain and their use of pain medications.

Results:
74% of eligible patients responded to the surveys (N=639). Prevalence of chronic pain was high: 61% in general primary care and diabetes samples and 65% in the CHF sample (p = .65). Those with pain were younger than those without pain (68 vs. 72 years, p<.001), more likely to rate their health as fair or poor (66% vs. 37%, p<.001), and to report not working due to their health (23% vs. 8%, p<.001). Those with chronic pain reported that, on average, pain interfered with things they wanted to do on more than half the days in the past month. Over three-quarters reported taking medication for their pain but of those fewer than 30% indicated the medications were more than moderately effective at controlling pain. Almost 30% of patients rated the quality of care they received for chronic pain as fair or poor.

Implications:
Over half of VA primary care patients report having chronic pain, and this prevalence varies little by presence of other chronic conditions. Chronic pain negatively affects health status, employment status, and daily functioning, even in populations with other chronic conditions. Despite the use of pain medication, substantial proportions of patients continue to experience poor pain control and are dissatisfied with the pain care they receive.

Impacts:
There is a high burden of chronic pain among VHA patients, and this burden is expected to increase as recently deployed veterans seek care in VHA. Innovative management strategies are necessary to mitigate the negative effects of chronic pain among our patients.


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