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Pain intensity and pain medication prescription patterns in Veterans with heart failure and back pain.

Cavanagh CE, Rosman L, Chui PW, DeRycke E, Bathulapalli H, Gandhi P, Bastian LA, Burg MM, Brandt C, Goulet JL. Pain intensity and pain medication prescription patterns in Veterans with heart failure and back pain. Heart & lung : the journal of critical care. 2021 Nov 1; 50(6):770-774.

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BACKGROUND: Pain and heart failure are highly comorbid. OBJECTIVES: The purpose of this study was to examine differences in pain intensity and pain medication prescriptions among Veterans with comorbid heart failure and pain and those with pain alone. METHODS: The Musculoskeletal Disorder (MSD) cohort includes 5,237,763 Veteran diagnosed with a musculoskeletal disorder between 2000 and 2013. Veterans with comorbid heart failure and back pain (heart failure+, n  =  3,950, M  =  70.5 ± 12) were compared to those with back pain alone (heart failure-, n  =  165,290, M  =  52.1 ± 17.5). RESULTS: In multivariate adjusted models, heart failure+ was associated with a higher likelihood of moderate/severe pain (OR  =  1.12; 95% CI 1.04-1.21), a higher likelihood of opioids (OR  =  1.63; CI  =  1.52-1.75) and/or gabapentin prescriptions (OR  =  1.18; CI  =  1.02-1.36), but a lower likelihood of NSAID prescriptions (OR  =  0.57; CI  =  0.50-0.66). CONCLUSIONS: Comorbid cardiovascular and pain conditions present a challenge in clinical management that warrants further study.

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