United States national pain strategy for population research: concepts, definitions, and pilot data.
Open accessAbstract
Unlabelled National Pain Strategy population research objectives include: estimating chronic pain prevalence, studying pain treatment with electronic health care data, and developing metrics to assess progress in reducing chronic pain impact. In this article, the National Pain Strategy Population Research Workgroup reviews concepts relevant to achieving these aims. High-impact chronic pain was defined as persistent pain with substantial restriction of life activities lasting 6 months or more. In pilot work, we tested a brief assessment of high-impact chronic pain, and used electronic health records data to describe pain-related health care. A mail survey of adult health plan enrollees (N = 770) reported that 14% had high-impact chronic pain. Relative to persons with lower-impact chronic pain, those with high-impact chronic pain were more often frequent users of health care for pain, reported lower quality of life, greater pain-related interference with activities, and more often reported pain at multiple anatomic locations. Analyses of health care data (N = 289,464) reported that pain patients had higher health care costs compared with others and that pain services were typically delivered in primary care. These results support the feasibility of developing data on chronic pain through national health interview surveys and large electronic health care databases.Perspective Pilot analyses supported the feasibility of brief chronic pain assessments suitable for national health surveys and use of electronic health care databases to develop data regarding trends in the delivery of pain treatments, costs, and effectiveness. These methods are relevant to achieving the aims of the US National Pain Strategy.
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The estimate of high-impact chronic pain in this study is similar to or slightly lower than estimates reported in the few studies that have looked at pain using a similar construct.
“This estimate of high-impact chronic pain is similar to or slightly lower than estimates reported in the few studies that have looked at pain using a similar construct.”
From Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016 (2018) · cites this paper as [7]
The HICP prevalence estimate is considerably lower than estimates based on pain interference.
“That this estimate is considerably lower than estimates based on pain interference11,36 is not unexpected.”
From Prevalence and Profile of High-Impact Chronic Pain in the United States (2019) · cites this paper as [36]
Definitions based solely on pain duration do not consider the multidimensional nature of chronic pain, namely activity limitations and participation restrictions.
“Although conceptually appealing, this hotly debated7 approach does not consider the multidimensional nature of chronic pain, namely, the presence of activity limitations and participation restrictions,5,17,30–36 classifications recognized by the World Health Organization.37”
From Prevalence and Profile of High-Impact Chronic Pain in the United States (2019) · cites this paper as [36]
The U.S. National Pain Strategy proposed the concept of high-impact chronic pain (HICP) to better identify those with significant levels of life interference.
“To address this shortcoming, the U.S. National Pain Strategy proposed the concept of high-impact chronic pain (HICP) to better identify those with significant levels of life interference (ie, work, social, and/or self-care activities).24,36”
From Prevalence and Profile of High-Impact Chronic Pain in the United States (2019) · cites this paper as [36]
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- Authors
- Von Korff, M., Scher, A. I., Helmick, C., Carter-Pokras, O., Dodick, D. W., Goulet, J., Hamill-Ruth, R., LeResche, L., Porter, L., Tait, R., Terman, G., Veasley, C., & Mackey, S.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Mayo Clinic (US)
- Yale University (US)
- University of Virginia Health System (US)
- University of Washington (US)
- National Institutes of Health (US)
- Saint Louis University (US)
- Stanford Medicine (US)
- ORCID
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 17
- Issue
- 10
- Pages
- 1068-1080
- ISSN
- 1526-5900 (ISSN-L)
- OpenAlex
- W2464049161
- Cited by
- 229
- References
- 40
- Citations by year
- 2026: 19 · 2025: 21 · 2024: 31 · 2023: 26 · 2022: 32 · 2021: 33 · 2020: 22 · 2019: 26 · 2018: 11 · 2017: 7 · 2016: 1
- FWCI
- 12.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- NINDS
- NIH Inter-Agency Pain Research Coordinating Committee (AG034181)
- Pfizer Inc.
- Healthlogix
- Haymarket Media Group, Ltd.
- SAGE Publishing
- Synergy
- Allergan
- Lippincott Williams & Wilkins
- Oxford University Press
- Cambridge University Press
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- chronic pain, high-impact chronic pain, health care costs, electronic health records, pain assessment tools, quality of life, primary care, health plan enrollees
- MeSH terms
- Adolescent, Adult, Aged, Feasibility Studies, Female, Humans, Interviews as Topic, Male, Middle Aged, Terminology as Topic, Pain Measurement, Pilot Projects, Psychiatric Status Rating Scales, Quality of Life, Surveys and Questionnaires, Research Design, United States, Prevalence, Databases, Factual, Health Care Costs, Young Adult, Electronic Health Records, Chronic Pain
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