Investigating pain in heart failure patients: the Pain Assessment, Incidence, and Nature in Heart Failure (PAIN-HF) study
Abstract
Background Patients with advanced heart failure (HF) have high rates of pain and other symptoms that diminish quality of life. We know little about the characteristics and correlates of pain in patients with advanced HF.Methods and results We identified pain prevalence, location, character, severity, frequency, and correlates in 347 outpatients with advanced HF enrolled from hospices and clinics. We evaluated the correlation of pain with HF-related quality of life, mortality, symptoms and health problems, and current treatments for pain. Pain at any site was reported by 293 patients (84.4%), and 138 (39.5%) reported pain at more than one site. The most common site of pain was the legs below the knees (32.3% of subjects). Pain interfered with activity for 70% of patients. Pain was "severe" or "very severe" for 28.6% of subjects with chest pain, and for 38.9% of those with other sites of pain. The only medication reported to provide pain relief was opioids, prescribed for 34.1% of subjects (P = .001). The strongest predictors of pain were degenerative joint disease (DJD) (odds ratio [OR] 14.95, 95% confidence interval [CI] 3.9-56.0; P < .001), other arthritis (OR 2.8, 95% CI 1.20-6.62; P = .017), shortness of breath (OR 3.27, 95% CI 1.47-7.28; P = .004), and angina pectoris (OR 3.38, 95% CI 1.30-8.81; P = .013).Conclusions Pain occurred at multiple sites in patients with advanced HF. Pain correlated with DJD or other arthritis, shortness of breath, and angina. Only opioid analgesics provided relief of pain. Future research should evaluate the etiology of and interventions to manage pain in patients with HF.
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Pain was most commonly cited in the legs and back, and more than a third experience pain in multiple sites.
“While pain was most commonly cited in the legs and back, more than a third experience pain in multiple sites. 85”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [85]
Opiates have an important role in CHF both in the early and later palliative stages of the disease and are safe, well tolerated, and effective.
“Opiates have an important role in CHF both in the early and later palliative stages of the disease and are safe, well tolerated, and effective. 85”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [85]
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- Authors
- Goodlin, S. J., Wingate, S., Albert, N. M., Pressler, S. J., Houser, J., Kwon, J., Chiong, J., Storey, C. P., Quill, T., & Teerlink, J. R.
- Affiliations
- Portland VA Medical Center (US)
- Kaiser Permanente (US)
- Cleveland Clinic (US)
- University of Michigan (US)
- Regis University (US)
- Loma Linda University (US)
- Loma Linda University Medical Center (US)
- University of Rochester (US)
- University of California, San Francisco (US)
- Corresponding author
- Goodlin, Sarah J.
- Venue
- Journal of Cardiac Failure
- Publisher
- Elsevier BV
- Published
- 2012-10
- Volume
- 18
- Issue
- 10
- Pages
- 776-783
- ISSN
- 1071-9164 (ISSN-L)
- OpenAlex
- W2010931476
- Cited by
- 115
- References
- 23
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 8 · 2023: 7 · 2022: 8 · 2021: 14 · 2020: 10 · 2019: 14 · 2018: 4 · 2017: 13 · 2016: 9 · 2015: 7 · 2014: 5 · 2013: 3
- FWCI
- 6.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiac Failure (publishedVersion)
- PubMed (publishedVersion)
- ePublications at Regis University (Regis University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- heart failure, pain, advanced heart failure, pain prevalence, pain localization, pain intensity, quality of life, opioids, osteoarthritis, arthritis, dyspnea, angina pectoris, pain management, predictors of pain
- MeSH terms
- Aged, Female, Health Status Indicators, Heart Failure, Humans, Male, Middle Aged, Pain, Pain Measurement, Quality of Life, Surveys and Questionnaires, United States, Comorbidity, Incidence, Confidence Intervals, Odds Ratio
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