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Dynamic Interactions in Chronic Pain-Related Outcomes: A Secondary Data Analysis of a Pragmatic Clinical Trial With
Dahee Wi1, Diane M Flynn2, Chang Park3
1Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL 60612, United States.
Military Medicine
|May 29, 2025
Summary
Understanding dynamic chronic pain outcomes is key. Pain interference, depression, anxiety, and fatigue are central, while sleep, physical function, and pain intensity evolve during treatment.
Area of Science:
- Pain Management
- Psychological Health
- Rehabilitative Care
Background:
- Chronic pain impacts psychological health and quality of life.
- Co-occurring issues include sleep impairment, fatigue, and pain catastrophizing.
- These factors interact and influence treatment success.
Purpose of the Study:
- To explore dynamic interactions among chronic pain outcomes.
- To analyze relationships in adults undergoing integrative health or standard care.
- To understand how these outcomes change during interventions.
Main Methods:
- Secondary analysis of a pragmatic clinical trial (NCT03297905).
- Data from 182 adults with chronic pain (pre- and post-intervention).
- Investigated 10 patient-reported outcomes using cross-sectional and cross-lagged panel network analyses.
Main Results:
- Cross-sectional networks: Pain interference, depression, anxiety, fatigue showed highest centrality.
- Cross-lagged panel network: Sleep impairment, pain interference, physical function, pain intensity had highest influence.
- Network analyses confirmed stability and moderate accuracy.
Conclusions:
- Cross-sectional data alone may miss evolving outcome relationships.
- Understanding dynamic patterns is crucial for refining interventions.
- Tailoring strategies to target key outcomes improves chronic pain management.
