Health-related quality of life differs significantly depending on the etiology of a patient’s neuropathic pain. This is evident from research published in the Scandinavian Journal of Pain.
Researchers attempted to compare two groups of patients with neuropathic pain of different etiologies – postoperative breast cancer patients and people living with HIV with sensory neuropathy – to assess health-related quality of life outcomes and potentially different patterns of personality, mood, and / or rating or pain-related disasters in these groups.
In addition, the researchers wanted to investigate whether these groups had different psychological factors that were responsible for health-related quality of life and pain interference measures.
Women with breast cancer (n = 89) were recruited from a study of 1,000 women treated at Helsinki University Hospital between 2006 and 2010. Patients with HIV (n = 73; 64 men) were recruited from outpatient clinics affiliated with the UK Chelsea and UK hospital Westminster Hospital NHS Foundation Trust and through national HIV charities between 2014 and 2017. All participants completed questionnaires basic demographic information as well as numerous questionnaires and interviews on pain and quality of life.
The results of the questionnaire showed that patients with HIV reported a significantly higher incidence of depressive symptoms, anxiety states, pain disasters and insomnia as well as lower values for tolerance, emotional stability and extroversion. These patients also had higher pain intensity and interference. The mean Douleur Neuropathique 4 interview part (DN4i) value was higher in the HIV cohort than in the breast cancer cohort (4.9 ± 1.2 versus 4.1 ± 0.95).
Analyzes of covariance (ANCOVA) were performed to allow researchers to control pain intensity in group comparisons. These differences remained significant for covariates across the model.
Patients in the HIV cohort also had lower mental and physical health scores for quality of life compared to the breast cancer cohort. In addition, the researchers found a positive correlation between fear and disaster in the HIV group (R2 = 0.41; 95% CI, 0.20-0.58 versus R2, 0.14; 95% CI, -0.07 up to 0.34).
Mood, as measured by the HADS (Hospital Anxiety and Depression Scale) score, was negatively associated with mental quality of life in both groups, with similar HADS regression coefficients in both groups (b = -0.580 and -0.591).
Lesser pain disorder was associated with better intellectual quality of life in the HIV group (b = -0.344), while higher extraversion and fewer symptoms in the breast cancer group were associated with better intellectual quality of life (b = 0.299 and b = – 0.154).
In both groups, younger age was associated with better physical quality of life and better mood in the HIV cohort. However, a higher pain catastrophe was associated with a lower physical quality of life in the breast cancer cohort.
The limitations of the study include the small size of each cohort, the cross-sectional nature of the study, and the researchers’ inability to draw conclusions as to whether the underlying disease or treatments (antiretroviral therapy or chemotherapy) in 2 either changed personality or catastrophic tendencies have “very different patient cohorts.”
Future research, which includes a questionnaire that focuses on patient experiences with stigma, may provide more insight into the differences between cohorts.
“Pain disorders and [health-related quality of life] showed similar negative associations in the groups, ”the researchers concluded. “The burden of disease can pose greater challenges to treatment interventions. Targeted interventions to treat specific symptoms, such as: B. Pain acceptance, sleep interventions, and active coping can be important. “
Disclosure: Several authors of the study have stated that they are part of the pharmaceutical industry. For a full list of the authors’ information, see the original reference.
Sipilä R., Kemp H., Harno H., Rice ASC, Kalso E. Health-related quality of life and pain disorders in two patient cohorts with neuropathic pain: breast cancer survivors and HIV patients. Scand J Pain. Published online March 16, 2021. doi: 10.1515 / sjpain-2020-0177
This article originally appeared on Clinical Pain Advisor