How Does Self-Declared Chronic Pain Compare to Other Definitions? A Prospective Multicenter Study

Area of Science:

• Pain Medicine
• Clinical Epidemiology

Background:

• Chronic pain definitions lack standardization, impacting research and clinical practice.
• Self-declared chronic pain has not been systematically compared against existing diagnostic criteria.
• Understanding agreement is crucial for defining chronic pain post-emergency department (ED) visits.

Purpose of the Study:

• To evaluate the agreement between self-declared chronic pain and established definitions.
• To compare chronic pain prevalence using different measurement criteria three months after an ED visit.
• To assess analgesic use patterns across various chronic pain definitions.

Main Methods:

• Prospective multicenter cohort study including 1411 adult patients discharged from the ED with acute pain and an opioid prescription.
• Assessment of self-declared chronic pain, pain intensity, frequency, and disability at three months post-ED visit.
• Calculation of agreement (kappas) between self-declared chronic pain and five other definitions.

Main Results:

• Prevalence of self-declared chronic pain was 23.0%, ranging from 16.9% to 45.3% with other definitions.
• Moderate agreement (kappa 0.57-0.60) was found between self-declared pain and most definitions, with lower agreement (kappa 0.47) for pain intensity ≥ 1.
• Analgesic use was similar across definitions, except for the pain intensity ≥ 1 definition, which showed lower use.

Conclusions:

• Self-declared chronic pain demonstrates moderate agreement with other definitions, suggesting potential as a patient-centered outcome.
• Chronic pain prevalence estimates vary widely depending on the definition employed.
• Standardizing chronic pain definition using self-declaration could improve clinical assessment and research consistency.