Impact of chronic pain on health care seeking, self care, and medication. Results from a population-based Swedish study.
Open accessAbstract
STUDY OBJECTIVE: To explore individual and social factors that could predict health care utilisation and medication among people with chronic pain in an unselected population. DESIGN: A mailed survey with questions about pain and mental symptoms, disability, self care action, visits to health care providers, and medication. SETTING: General populations in two Swedish primary health care (PHC) districts. Medical care was given in a state health system. PARTICIPANTS: A random sample (from the population register) of 15% of the population aged 25-74 (n = 1806). MAIN RESULTS: Among people reporting chronic pain 45.7% (compared with 29.8 of non-chronic pain persons, p < 0.05) consulted a physician and 7.2% (compared with 1.2%, p < 0.05) a physiotherapist during three months. Primary health care was the most frequent care provider. High pain intensity, aging, depression, ethnicity, and socioeconomic level had the greatest impact on physician consultations. Alternative care, used by 5.9%, was associated with high pain intensity and self care. Use of self care was influenced by high pain intensity, regular physical activity, and ethnicity. Alternative care and self care did not imply lower use of conventional health care. Women reporting chronic pain consumed more analgesics and sedatives than corresponding men. Besides female gender, high pain intensity, insomnia, physician consultation, social network, and self care action helped to explain medication with analgesics. Use of herbal remedies and ointments correlated to self care action, visit to an alternative therapist, high pain intensity, and socioeconomic level. CONCLUSIONS: The presence of chronic pain has an impressive impact on primary health care and medication. Various therapeutic actions are common and are partly overlapping. The use of health care among people with chronic pain depends above all on pain perception and intensity of pain but is also affected by ethnicity, age, socioeconomic level, and depressive symptoms. Among people with chronic pain use of analgesics is common in contrast with other types of pain relief (acupuncture, physiotherapy) suitable for treating chronic pain symptoms.
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Patients with chronic pain visit their GP twice as often as patients without chronic pain.
“Patients with chronic pain visit their GP twice as often as patients without chronic pain [19].”
From Identification and Management of Chronic Pain in Primary Care: a Review (2016) · cites this paper as [19]
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Cites
Chronic Pain in a Geographically Defined General Population
Andersson, H. I., Ejlertsson, G., Leden, I., Rosenberg, C., & Bromölla Health Centre (1993) · Clinical Journal of Pain · doi:10.1097/00002508-199309000-00004 · Cited by 694 · see citing works
Self-citationThe prevalence of pain in a general population. The results of a postal survey in a county of Sweden
Brattberg, G., Thorslund, M., & Wikman, A. (1989) · Pain · doi:10.1016/0304-3959(89)90133-4 · Cited by 468 · see citing works
Comparison of self-reported and medical record health care utilization measures
Roberts, R. O., Bergstralh, E. J., Schmidt, L., & Jacobsen, S. J. (1996) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(96)00143-6 · Cited by 358 · see citing works
Verbrugge, L. M., & Ascione, F. J. (1987) · Medical Care · doi:10.1097/00005650-198706000-00008 · Cited by 257 · see citing works
Gender roles, illness orientation and use of medical services
Hibbard, J. H., & Pope, C. R. (1983) · Social Science & Medicine · doi:10.1016/0277-9536(83)90246-0 · Cited by 230 · see citing works
Use of non-orthodox and conventional health care in Great Britain.
Thomas, K. J., Carr, J., Westlake, L., & Williams, B. T. (1991) · BMJ · doi:10.1136/bmj.302.6770.207 · Cited by 211 · see citing works
Why do people consult the doctor?
Campbell, S., & Roland, M. O. (1996) · Family Practice · doi:10.1093/fampra/13.1.75 · Cited by 191 · see citing works
Chronic pain and use of ambulatory health care.
Korff, M. V., Wagner, E. H., Dworkin, S. F., & Saunders, K. W. (1991) · Psychosomatic Medicine · doi:10.1097/00006842-199101000-00006 · Cited by 164 · see citing works
Rekola, K. E., Keinanen-Kiukaanniemi, S. M., & Takala, J. (1993) · Journal of Epidemiology & Community Health · doi:10.1136/jech.47.2.153 · Cited by 161 · see citing works
Who??s Using Nonprescribed Medicines?
Bush, P. J., & Rabin, D. L. (1976) · Medical Care · doi:10.1097/00005650-197612000-00005 · Cited by 87 · see citing works
Pattern of Drug Use in a General Population—Prevalence and Predicting Factors: The Tromsø Study
Eggen, A. E. (1994) · International Journal of Epidemiology · doi:10.1093/ije/23.6.1262 · Cited by 80 · see citing works
Ethnic variations in the chronic pain experience.
Bates, M. S., & Edwards, W. (1992) · PubMed · Cited by 65 · see citing works
Antonov, K., & Isacson, D. G. L. (1996) · Social Science & Medicine · doi:10.1016/0277-9536(96)87321-7 · Cited by 59 · see citing works
Bucquet, D., & Curtis, S. E. (1986) · Social Science & Medicine · doi:10.1016/0277-9536(86)90122-x · Cited by 57 · see citing works
Potter, R., & Jones, J. M. (1992) · PubMed · Cited by 56 · see citing works
Chronic Pain and the Sociodemographic Environment
Ektor-Andersen, J., Janzon, L., & Sjölund, B. H. (1993) · Clinical Journal of Pain · doi:10.1097/00002508-199309000-00005 · Cited by 53 · see citing works
Self-Care of Common Illnesses in Denmark
Dean, K. J., HOLST, E. J., & WAGNER, M. G. (1983) · Medical Care · doi:10.1097/00005650-198310000-00007 · Cited by 46 · see citing works
Immigration and Socio-economy as Predictors of Early Retirement Pensions
Edén, L., Ejlertsson, G., Lamberger, B., et al. (1994) · Scandinavian Journal of Social Medicine · doi:10.1177/140349489402200305 · Cited by 41 · see citing works
Self-citationEpidemiology of Musculoskeletal Complaints and Use of Health Services in Asturias, Spain
García, F. J. B., Mejía, R. H., Lascuevas, P. M., et al. (1994) · Scandinavian Journal of Rheumatology · doi:10.3109/03009749409103046 · Cited by 33 · see citing works
Self-referral to primary care: Symptoms and social factors
Ingham, J. G., & Miller, P. M. (1986) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(86)90065-6 · Cited by 33 · see citing works
Factors Affecting Primary Health Care Utilization
Grimsmo, A., & Siem, H. (1984) · Family Practice · doi:10.1093/fampra/1.3.155 · Cited by 30 · see citing works
Wessling, A. (1987) · European Journal of Clinical Pharmacology · doi:10.1007/bf00610372 · Cited by 22 · see citing works
Responses to illness and health in chronic pain patients and healthy adults.
Egan, K. J., & Katon, W. J. (1987) · Psychosomatic Medicine · doi:10.1097/00006842-198709000-00004 · Cited by 18 · see citing works
Sundquist, J., Rosén, U., & Johansson, S. (1994) · International Journal of Social Welfare · doi:10.1111/j.1468-2397.1994.tb00228.x · Cited by 14 · see citing works
Access to medical care among persons with musculoskeletal conditions
Yelin, E., Bernhard, G. C., & Pflugrad, D. (1995) · Arthritis & Rheumatism · doi:10.1002/art.1780380816 · Cited by 14 · see citing works
Responses to illness and health in chronic pain patients and healthy adults
(1988) · Pain · doi:10.1016/0304-3959(88)90240-0 · Cited by 2 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Sundquist J, Rosén U, Johansson SE. Ethnicity as a risk indicator for musculoskeletal disease, long consultation times and care utilization. Scand J Soc Welfare 1994;3:212- 17.
Cited by
Sorted by citations
Epidemiology of insomnia: what we know and what we still need to learn
Ohayon, M. M. (2002) · Sleep Medicine Reviews · doi:10.1053/smrv.2002.0186 · Cited by 3,743 · see citing works
A review of chronic pain impact on patients, their social environment and the health care system
Duenas, M., Ojeda, B., Salazar, A., Mico, J. A., & Failde, I. (2016) · Journal of Pain Research · doi:10.2147/jpr.s105892 · Cited by 985 · see citing works
Meta-analysis of psychological interventions for chronic low back pain
Hoffman, B. M., Papas, R. K., Chatkoff, D. K., & Kerns, R. D. (2007) · Health Psychology · doi:10.1037/0278-6133.26.1.1 · Cited by 844 · see citing works
Rayner, L., Hotopf, M., Petkova, H., Matcham, F., Simpson, A., & McCracken, L. M. (2016) · Pain · doi:10.1097/j.pain.0000000000000542 · Cited by 290 · see citing works
Identification and Management of Chronic Pain in Primary Care: a Review
Mills, S., Torrance, N., & Smith, B. H. (2016) · Current Psychiatry Reports · doi:10.1007/s11920-015-0659-9 · Cited by 216 · see citing works
Timmerman, L., Stronks, D. L., Groeneweg, J. G., & Huygen, F. J. (2016) · Acta Anaesthesiologica Scandinavica · doi:10.1111/aas.12697 · Cited by 132 · see citing works
Epidemiology of Chronic Pain in Denmark and Sweden
Harker, J., Reid, K. J., Bekkering, G. E., Kellen, E., Bala, M. M., Riemsma, R., Worthy, G., Misso, K., & Kleijnen, J. (2012) · Pain Research and Treatment · doi:10.1155/2012/371248 · Cited by 94 · see citing works
Chronic pain and the use of conventional and alternative therapy
Haetzman, M., Elliott, A., Smith, B., Hannaford, P., & Chambers, W. (2003) · Family Practice · doi:10.1093/fampra/20.2.147 · Cited by 94 · see citing works
Primary care patients with musculoskeletal pain
Atroshi, I., Andersson, I. H., Gummesson, C., Leden, I., Odenbring, S., & Ornstein, E. (2002) · Scandinavian Journal of Rheumatology · doi:10.1080/030097402320318440 · Cited by 41 · see citing works
Self-citationThe cost of chronic pain: an analysis of a regional pain management service in Ireland
Gannon, B., Finn, D. P., O'Gorman, D., Ruane, N., & McGuire, B. E. (2013) · Pain Medicine · doi:10.1111/pme.12202 · Cited by 35 · see citing works
- Authors
- Andersson, H. I., Ejlertsson, G., Leden, I., & Scherstén, B.
- Affiliations
- Centralsjukhuset Kristianstad (SE)
- Lund University (SE)
- ORCID
- Andersson, H I
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 1999-08
- Volume
- 53
- Issue
- 8
- Pages
- 503-509
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- PMC
- PMC1756941
- OpenAlex
- W1998420492
- Cited by
- 183
- References
- 26
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 3 · 2021: 9 · 2020: 8 · 2019: 3 · 2018: 8 · 2017: 6 · 2016: 10 · 2015: 8 · 2014: 8 · 2013: 8 · 2012: 7
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Epidemiology & Community Health (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Högskolan Kristianstad Publikationer (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- chronic pain, health care utilization, self-care, analgesic use, pain intensity, physician consultation, complementary and alternative medicine, herbal medicine, physiotherapy, socioeconomic status, depression, gender differences, insomnia, primary care, social networks
- MeSH terms
- Activities of Daily Living, Adult, Aged, Analgesics, Chronic Disease, Delivery of Health Care, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Primary Health Care, Self Care, Self Medication, Sweden, Pain Management
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