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Pain intensity and pain medication prescription patterns in Veterans with heart failure and back pain
Casey E Cavanagh1, Lindsey Rosman2, Philip W Chui3
1Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, PO Box 800223, Charlottesville, VA 22908, USA.
Background:
Pain and heart failure are highly comorbid.
Objectives:
The purpose of this study was to examine differences in pain intensity and pain medication prescriptions among Veterans with comorbid heart failure and pain and those with pain alone.
Methods:
The Musculoskeletal Disorder (MSD) cohort includes 5,237,763 Veteran diagnosed with a musculoskeletal disorder between 2000 and 2013. Veterans with comorbid heart failure and back pain (heart failure+, n = 3,950, Mage = 70.5 ± 12) were compared to those with back pain alone (heart failure-, n = 165,290, Mage = 52.1 ± 17.5).
Results:
In multivariate adjusted models, heart failure+ was associated with a higher likelihood of moderate/severe pain (OR = 1.12; 95% CI 1.04-1.21), a higher likelihood of opioids (OR = 1.63; CI = 1.52-1.75) and/or gabapentin prescriptions (OR = 1.18; CI = 1.02-1.36), but a lower likelihood of NSAID prescriptions (OR = 0.57; CI = 0.50-0.66).
Conclusions:
Comorbid cardiovascular and pain conditions present a challenge in clinical management that warrants further study.
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