Researchers at West Park Healthcare Centre and University of Toronto in Canada recently suggested that reliable measures of pain are needed for patients with chronic obstructive pulmonary disease (COPD). The study was published in the journal Chest and is entitled “Pain and its clinical associations in individuals with chronic obstructive pulmonary disease (COPD): a systematic review.”
COPD is one of the most common lung diseases and a major cause of morbidity and mortality worldwide. In the United States it is the third leading cause of death. COPD is a progressive disease in which individuals develop serious breathing problems such as obstruction of the airways, shortness of breath (dyspnea) and acute exacerbations. Pain has also been reported as a clinical complication of COPD, although its impact and the measures used to assess pain require further evaluation.
In this study, researchers conducted a systematic review of published studies in five different databases up to September 2014. The review was performed in two distinct phases: studies included in phase 1 reported an association between prevalence and pain in patients with COPD, while in phase 2 studies concerning measurement properties of tools to assess pain in COPD patients were considered. 358 studies were identified but only 9 met the inclusion criteria for phase 1 and five for phase 2.
The definition of pain differed among the studies, nonetheless, an overall pain prevalence of 66% was found in patients with moderate to severe COPD, with pain being reported more often in the lower limbs, upper limbs and chest. Higher pain intensity was found to be linked to a greater amount of specific comorbidities, increased dyspnea and fatigue, and poorer quality of life.
Concerning the pain assessment tools, phase 2 revealed that several questionnaires were used to evaluate pain, like the brief pain inventory (BPI), the McGill pain questionnaire (MPQ) and a health-related quality of life (HRQOL) questionnaire. The researchers concluded that the burden to assess pain in BPI and MPG questionnaires is low, making either of them a feasible choice to provide information regarding pain and related clinical factors in COPD. The team believes that due to the availability of more comprehensive studies on BPI, it might currently be the best choice in clinical practice.
The researchers concluded that pain has a negative association with symptoms and quality of life in COPD patients, and indicate the need of further studies to establish tools to assess and classify pain in these patients.