Evidence map›Paper›PMID 27267905›Full record

Observational studyBMC family practice2016

Association between multimorbidity patterns and chronic pain in elderly primary care patients: a cross-sectional observational study.

Martin Scherer, Heike Hansen, Jochen Gensichen, Karola Mergenthal, Steffi Riedel-Heller, Siegfried Weyerer, Wolfgang Maier, Angela Fuchs, Horst Bickel, Gerhard Schön and 4 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC family practice, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 3 pooled it
6.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 3 syntheses or guidelines pooled it, 108 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 1 country.

Martin SchererDepartment of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Heike HansenDepartment of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jochen GensichenInstitute of General Practice, University of Jena, Jena, Germany.
Karola MergenthalInstitute of General Practice, University of Frankfurt am Main, Frankfurt am Main, Germany.
Steffi Riedel-HellerInstitute for Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
Siegfried WeyererCentral Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
Wolfgang MaierDepartment of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
Angela FuchsInstitute of General Practice, University of Düsseldorf, Düsseldorf, Germany.
Horst BickelDepartment of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany.
Gerhard SchönDepartment of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Birgitt WieseInstitute for General Practice, Hannover Medical School, Hannover, Germany.
Hans-Helmut KönigDepartment of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Hendrik van den BusscheDepartment of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Ingmar SchäferDepartment of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. in.schaefer@uke.de.
Universität Hamburg · DEUniversity Medical Center Hamburg-Eppendorf · DEGoethe University Frankfurt · DEHeidelberg University · DEHeinrich Heine University Düsseldorf · DELeipzig University · DEMedizinische Hochschule Hannover · DETechnical University of Munich · DEUniversity of Bonn · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultimorbidity is a highly prevalent health problem, which may reduce adherence, produce conflicts in treatment, and is not yet supported by evidence-based clinical recommendations. Many older people suffer from more than one chronic disease as well as from chronic pain. There is some evidence that disease management can become more complex if multimorbid patients suffer from chronic pain. In order to better consider the patients' comorbidity spectrum in clinical pain treatment recommendations, evidence is needed regarding which disease combinations are frequently related with the presence of chronic pain. Therefore, our aim is to identify diseases and disease combinations in a multimorbid population, which are associated with the patient-reported presence of chronic pain.

methodsAnalyses are based on cross-sectional data of the MultiCare Cohort Study, an observational cohort study based on interviews with 3189 multimorbid patients aged 65+, randomly selected from 158 practices, and their GPs. The response rate was 46.2 %. Data were collected in GP interviews and comprehensive patient interviews. Diseases and disease combinations associated with chronic pain were identified by CART (classification and regression tree) analyses performed separately for both genders. 46 chronic conditions were used as predictor variables and a dichotomized score from the Graded Chronic Pain Scale was used as outcome variable.

resultsAbout 60 % of the study participants were female. Women more often reported chronic pain than men. The most important predictor of a higher pain level in the female population was chronic low back problems, especially if combined with chronic gastritis, hyperuricemia/gout, cardiac insufficiency, neuropathies or depression. Regarding the pain level the male population was also divided best by chronic low back problems, especially if combined with intestinal diverticulosis, neuropathies or chronic ischemic heart disease.

conclusionsOur analyses are a first step in identifying diseases and disease combinations that are related to chronic pain. The most important condition seems to be low back problems. Back pain and pain in other body regions seems to be interrelated with cardiometabolic conditions. In women, psychosocial issues like depression also seem to be relevant.

trial registrationISRCTN89818205 .

Indexed as

ComorbidityAgedAged, 80 and overChronic DiseaseChronic PainCross-Sectional StudiesDepressionDiverticulumFemaleGastritisGoutHeart FailureHumansMaleMusculoskeletal DiseasesNervous System DiseasesCART analysisChronic painEpidemiologyExporative analysisLow back painMultimorbidityPatient-reported outcomes

Identifiers

PMID27267905
PMCPMC4895952
OpenAlexW2419464083

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.