Eva Ørnbøl

TY - JOUR

T1 - Application of ICD-11 among individuals with chronic pain

T2 - A post hoc analysis of the Stanford Self-Management Program

AU - Hornemann, Christina

AU - Schröder, Andreas

AU - Ørnbøl, Eva

AU - Christensen, Nils Balle

AU - Høeg, Marian Dalgaard

AU - Mehlsen, Mimi

AU - Frostholm, Lisbeth

N1 - © 2019 European Pain Federation - EFIC®.

PY - 2020/2

Y1 - 2020/2

N2 - BACKGROUND: Chronic primary pain (CPP) is one of seven diagnostic groups within the proposed classification of chronic pain in ICD-11. Our aims were to apply the proposed ICD-11 criteria in a large cohort of chronic pain patients participating in the Chronic Pain Self-Management Program (CPSMP) and further investigate whether participants with CPP differed from participants with chronic secondary pain (CSP) regarding health, health expenditure and the effect of participating in the CPSMP.METHODS: A secondary analysis of a randomized, controlled trial on the effect of the CPSMP. Four examiners categorized participants' pain according to ICD-11 using register-based medical diagnoses and patients' self-reported symptoms. Afterwards, differences between CPP and CSP were examined.RESULTS: Out of 394 participants, 312 were successfully classified into CPP (n = 164) or CSP (n = 148) whereas 76 had a mixed pain condition. Participants with CPP were younger, more likely to be women, and had longer pain duration compared to participants with CSP. Participants with CPP reported worse health-related quality of life on the SF-36 Mental Component Summary and subscales of vitality, social functioning and bodily pain. Participants with CSP had more physical comorbidities and higher total health expenditure. None of the groups benefitted from the CPSMP.CONCLUSIONS: We successfully applied the new classification of chronic pain in ICD-11 on the basis of ICD-10 medical diagnoses and symptom self-report. Participants with CPP differed significantly from participants with CSP on baseline characteristics, self-reported health measures and total health expenditure. The CPSMP was not effective in any of the groups.SIGNIFICANCE: The current study applies the proposed new classification of chronic pain in ICD-11 and shares the experiences of the diagnostic rating procedure of individuals with chronic pain. Furthermore, it evaluates the effect of the Stanford Self-Management Program.

AB - BACKGROUND: Chronic primary pain (CPP) is one of seven diagnostic groups within the proposed classification of chronic pain in ICD-11. Our aims were to apply the proposed ICD-11 criteria in a large cohort of chronic pain patients participating in the Chronic Pain Self-Management Program (CPSMP) and further investigate whether participants with CPP differed from participants with chronic secondary pain (CSP) regarding health, health expenditure and the effect of participating in the CPSMP.METHODS: A secondary analysis of a randomized, controlled trial on the effect of the CPSMP. Four examiners categorized participants' pain according to ICD-11 using register-based medical diagnoses and patients' self-reported symptoms. Afterwards, differences between CPP and CSP were examined.RESULTS: Out of 394 participants, 312 were successfully classified into CPP (n = 164) or CSP (n = 148) whereas 76 had a mixed pain condition. Participants with CPP were younger, more likely to be women, and had longer pain duration compared to participants with CSP. Participants with CPP reported worse health-related quality of life on the SF-36 Mental Component Summary and subscales of vitality, social functioning and bodily pain. Participants with CSP had more physical comorbidities and higher total health expenditure. None of the groups benefitted from the CPSMP.CONCLUSIONS: We successfully applied the new classification of chronic pain in ICD-11 on the basis of ICD-10 medical diagnoses and symptom self-report. Participants with CPP differed significantly from participants with CSP on baseline characteristics, self-reported health measures and total health expenditure. The CPSMP was not effective in any of the groups.SIGNIFICANCE: The current study applies the proposed new classification of chronic pain in ICD-11 and shares the experiences of the diagnostic rating procedure of individuals with chronic pain. Furthermore, it evaluates the effect of the Stanford Self-Management Program.

KW - BEHAVIORAL GROUP TREATMENT

KW - CENTRAL SENSITIZATION

KW - FUNCTIONAL SOMATIC SYNDROMES

KW - ILLNESS PERCEPTIONS

KW - LOW-BACK-PAIN

KW - MEDICALLY UNEXPLAINED SYMPTOMS

KW - OLDER-ADULTS

KW - QUALITY-OF-LIFE

KW - RANDOMIZED CONTROLLED-TRIAL

KW - RHEUMATOID-ARTHRITIS

U2 - 10.1002/ejp.1486

DO - 10.1002/ejp.1486

M3 - Journal article

C2 - 31556212

VL - 24

SP - 297

EP - 311

JO - European Journal of Pain

JF - European Journal of Pain

SN - 1090-3801

IS - 2

ER -