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Unresolved Pain Interference among Colorectal Cancer Survivors: Implications for Patient Care and Outcomes
Author(s) -
Kenzik Kelly,
Pisu Maria,
Johns Shelley A.,
Baker Tamara,
Oster Robert A.,
Kvale Elizabeth,
Fouad Mo.,
Martin Michelle Y.
Publication year - 2015
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/pme.12727
Subject(s) - medicine , logistic regression , colorectal cancer , depression (economics) , cancer , comorbidity , oncology , economics , macroeconomics
Objective Using a large sample of colorectal cancer (CRC) survivors we 1) describe pain interference (PI) prevalence across the cancer continuum; 2) identify demographic and clinical factors associated with PI and changes in PI; and 3) examine PI's relationship with survivors’ job changes. Methods CRC participants of the Cancer Care Outcomes Research and Surveillance Consortium completed surveys during the initial phase of care (baseline, < 1 year, n  = 2,961) and follow‐up (about 1‐year postdiagnosis, n  = 2,303). PI was measured using the SF‐12 item. Multiple logistic regression was used to identify predictors of PI. Model 1 evaluated moderate/high PI at baseline, Model 2 evaluated new/continued/increasing PI postdiagnosis follow‐up, and Model 3 restricted to participants with baseline PI ( N  = 603) and evaluated predictors of equivalent/increasing PI. Multivariable logistic regression was also used to examine whether PI predicted job change. Results At baseline and follow‐up, 24.7% and 23.7% of participants reported moderate/high PI, respectively. Among those with baseline PI, 46% had equivalent/increasing PI at follow‐up. Near diagnosis and at follow‐up, female gender, comorbidities, depression, chemotherapy and radiation were associated with moderate/high PI while older age was protective of PI. Pulmonary disease and heart failure comorbidities were associated with equivalent/increasing PI. PI was significantly associated with no longer having a job at follow‐up among employed survivors. Conclusion Almost half of survivors with PI during the initial phase of care had continued PI into post‐treatment. Comorbidities, especially cardiovascular and pulmonary conditions, contributed to continued PI. PI may be related to continuing normal activities, that is, work, after completed treatment. © 2015 Wiley Periodicals, Inc.

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