A secondary analysis of how changes in pain interference relate to changes in health-related quality of life and physical function in heart failure.
Asa B Smith, Miyeon Jung, Susan M Perkins and 2 others
PMID 42407429WHAT IT FOUND
In adults with heart failure, worsening pain interference tended to track with worsening physical function and quality of life over time.
The links were modest and observational, so they do not prove pain treatment improves either outcome.
Key findings
01In the adjusted model, improvement in pain interference over time was associated with improvement in physical function over time (F = 0.33, p = .038, 95% CI: 0.02 to 0.63).
02In the adjusted model, improvement in pain interference over time was associated with improvement in health-related quality of life over time (F = 1.62, p = .003, 95% CI: 0.05 to 2.70).
03Across timepoints, 52.6% to 54.1% of participants reported at least a few or some limitation in activities due to pain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
Pain interference was measured with a four-category item derived from two questions, not a detailed pain assessment. The current analysis used 240 or 212 of the 256 randomized parent-study participants, and 28 lacked physical function data. The sample was 85.7% White, limiting generalizability. The analysis was observational and could not estimate causal effects. A large share of participants had no change in pain interference between timepoints: 51.8% to 56.7% in the physical function analysis and 38.8% to 45.3% in the quality of life analysis. The parent trial did not target pain, and pain type, location, and acute versus chronic status were not measured. The quality of life estimate was below the paper's 5-point minimum clinically meaningful difference.
Declared interests
One author reports employment and financial support and statistical analysis provided by Indiana University Indianapolis. Other authors declared no competing interests.
The easy way to misread this
Do not conclude that treating pain will improve physical function or quality of life. This analysis observed associations over time, did not test a pain treatment, and the paper states the quality of life estimate was below its clinically meaningful threshold.