Noone D, Chai-Adisaksopha C, Curtis R, Frick N, Nichol M, O’Mahony B, Page D, Pastarnak A, Stonebraker J, Iorio A, Skinner M. Impact of Acute and Chronic Pain on the EQ-5D: Insights From The PROBE Study. Poster Presentations #P079. Haemophilia. 2019;25(S1):35-188. https://doi.org/10.1111/hae.13666
Background
Acute and chronic pain as well as the potential access to medications, including haemophilia specific products, significantly impact the quality of life of people with haemophilia (PWH). Generic questionnaires such as the EQ-5D are used to measure the impact of the condition on life experience. EQ-5D in particular is designed to record the individual experience on the day of completion. There is little information on how the response to the pain domain in EQ-5D is driven by acute or chronic pain. The Patient Reported Outcomes, Burdens and Experiences (PROBE) is a questionnaire developed by patients to measure what matters to them in a way that allows comparison with people without bleeding disorders.
Aim and methods
We hypothesized that joint analysis of EQ-5D and PROBE measures would allow deeper understanding of the impact of acute and chronic pain on the respective scores. Descriptive and correlation analysis were performed.
Results
Of 1287 respondents, 686 have severe haemophilia and were examined in this article. We identified 4 subgroups based on responses to PROBE questions asking about acute and chronic pain: no pain (NP, 12.46%), acute pain (AP, 16.13%), chronic pain (CP, 16.23%) and both chronic and acute pain (A/CP, 55.13%). The mean (SD) ages for NP, AP, CP and A/CP were 27.5 (18.3), 24.8 (15.0), 39.2 (15.57) and 37.6 (16.0), respectively. There was a weak correlation (r =0.21, Pearson) between chronic and acute pain.
The mean (SD) EQ-5D utility values for NP, AP, CP and A/CP were 0.91 (0.12), 0.82 (0.21), 0.75 (0.17) and 0.65 (0.28), respectively. Standard t-tests indicated that all groups were statistically different from each other. A similar trend was seen in VAS score.
Conclusion
Acute pain has a significant impact on the quality of life of PWH. This is further exacerbated by the presence of chronic pain and the combination of both leads to the greatest decrease in quality of life. The EQ-5D does discern a difference between both types of pain. However, if chronic pain only is present at the time the EQ-5D is administered, the result may mask the full extent of the impact on the utility value unless the context and timing of using these generic tools is understood. It may lead to a misrepresentation of the true nature of pain within the severe haemophilia population.
View Poster: Impact of Acute and Chronic pain on the EQ-5D
