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The Characteristics of Pain in Patients Diagnosed with Depression and Heart Failure
Christine Haedtke1, Marianne Smith2, John VanBuren3
1University of Kentucky, College of Nursing, Lexington, Kentucky.
Insights
Depressed heart failure patients frequently experience moderate to severe pain and significant pain interference. Nonpharmacologic pain treatments are underused, indicating a need for better pain management strategies in this population.
Area of Science:
- Cardiology
- Psychiatry
- Pain Management
Background:
- Heart failure (HF) is a significant health concern.
- Chronic pain and depression are common comorbidities in HF patients.
- Effective management of pain and depression is crucial for HF patient outcomes.
Purpose of the Study:
- To characterize pain and its management in patients with heart failure and depression.
- To identify patterns of pain intensity, interference, and treatment utilization.
- To explore differences in pain experience between genders in this population.
Main Methods:
- Descriptive cross-sectional study of 62 participants with depression and Class II-IV HF.
- Data collected using Brief Pain Inventory, Beck Depression Inventory, and Rand-36.
- Analysis of pain characteristics, interference, and treatment modalities.
Main Results:
- 98% reported pain in the past month; 66% in the past 24 hours.
- Median pain score was 4/10; median pain interference score was 4.42/10.
- All participants used pain medication, but only 5% used nonpharmacologic treatments.
- Women reported higher pain intensity and interference than men.
- Pain appeared ineffectively treated, with significant underuse of nonpharmacologic options.
Conclusions:
- Depressed HF patients experience substantial pain and functional interference.
- Nonpharmacologic pain management strategies are underutilized in this cohort.
- Targeted interventions and increased screening, especially for women, are needed for better pain control.
Abstract:
Heart failure (HF) is a costly and growing health problem that is routinely complicated by chronic pain and depression. The purpose of this paper is to describe the characteristics of pain and pain management in depressed HF patients. In this descriptive cross-sectional study, we analyzed data from 62 participants with depression and class II-IV HF. Study variables of interest were collected from the Brief Pain Inventory, Beck Depression Inventory, and Rand-36. Almost all participants (98%) had some pain in the past month and most had pain in the last 24 hours (66%). The median pain score was 4 (0-10 scale) with the majority reporting moderate to severe pain. The median pain interference score was 4.42 (0-10 scale) with the majority reporting moderate to extreme interference. Medication to treat pain was used by all participants who reported pain, with only 5% also using nonpharmacologic treatment. The majority of participants reported moderate or severe pain while also having moderate to extreme pain interference. Nonpharmacologic pain treatments were severely underused. Women were more likely to have higher levels of pain intensity and more pain interference than men, suggesting that additional screening for the impact of pain is especially important in women. The wide variety of body areas affected, along with moderate to high intensity pain and considerable interference scores reported, indicate that pain was ineffectively treated. Nonpharmacologic treatments should be considered to decrease the impact of pain.
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