The Characteristics of Pain in Patients Diagnosed with Depression and Heart Failure.
Christine Haedtke, Marianne Smith, John VanBuren and 2 others
PMID 28843637WHAT IT FOUND
Most older patients with heart failure and depression in this study had pain in the last 24 hours.
Pain was moderate, often in back, hips, or lower legs. Most who reported treatments used medications only, especially opioids.
Key findings
0166% of depressed heart failure participants reported pain in the last 24 hours, with median pain intensity 4.0 and median pain interference 4.42 on 0 to 10 scales.
02The most commonly reported painful body areas were the back, hips or upper legs, and lower legs; chest, neck, and shoulder pain were less often reported.
03Of 30 participants who reported pain treatments, 95% used medications only; opioids were most common, followed by acetaminophen, and only two reported treatments in addition to medication.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis was a small subset of 62 participants from an ongoing trial, so it may not represent all patients with heart failure and depression. All participants had depressive symptoms, so the study could not compare pain in people with and without depression. Participants were mostly male, white, non-Hispanic, married, and had low income, and recruitment occurred in an area of low racial and ethnic diversity, limiting generalizability. Only 30 of 62 participants reported pain treatments. The relief question included participants with no pain, so relief is hard to interpret. The study was descriptive and cross-sectional, so it cannot show why pain occurred or whether any treatment worked. Data collection did not allow interviewing participants, so pain causes and treatment context were not explored.
Declared interests
All authors declared no disclosures or conflicts of interest. The publication types list NIH extramural research support.
The easy way to misread this
Do not read the 56% little or no relief as evidence that pain treatments failed for patients with pain. Sixteen respondents had no pain in the last 24 hours and also reported no relief, and only four people who had pain reported little or no relief.