A review of chronic pain impact on patients, their social environment and the health care system

Figures & data

Figure 1 Biopsychosocial model of pain and consequences on the quality of life.

Table 1 Quality criteria for the assessment of the observational studies (criteria to be answered with yes/no/unclear)

Criteria
Adequate description of study design and setting
Adequate description of eligibility criteria (include description of diagnostic criteria for chronic pain condition)
Study population is representative of target population (sample size, sample selection, demographics)
Adequate description of outcomes (and how/how often measured), exposures, predictors
Adequate description of statistical methods (include description of potential confounders and effect modifiers and how they were dealt with)
Adequate description of study participants
Adequate description of losses to follow-up (for longitudinal studies), loss to follow-up less than 10% at 12 months or less than 25% for longer follow-up
Results reported as unadjusted and confounder-adjusted including precision

Table 2 Details and methodological quality of selected studies

Studies	Design	Participants	n	Question relevance	Methodological quality assessment
Breivik et al^Citation1	Observational survey	Adult general population aged ≥18 years	4,839	Activities of daily living, work, costs	Low
Langley et al^Citation2	Cross-sectional study. Internet survey	Adult general population	5,039	Quality of life, health care system, work	Medium
Leadley et al^Citation3	Review	–	–	Costs	–
Dueñas et al^Citation4	Cross-sectional nationwide study	Adult general population aged ≥18 years	1,957	Activities of daily living, family, work	High
Closs et al^Citation5	Qualitative study, focus groups	Adults patients with neuropathic pain	11	Family, social, and working relations	Low
Ojeda et al^Citation6	Cross-sectional nationwide study	Adult general population aged ≥18 years	1,957	Family	High
Reid et al^Citation8	Review of primary studies or systematic reviews	–	–	Quality of life, costs	–
Langley et al^Citation9	Cross-sectional study. Internet survey	Adult general population	5,039	Quality of life, health care system	Medium
Miro et al^Citation10	Cross-sectional survey	Population aged over 65 years	592	Activities of daily living	Medium
Bassols et al^Citation11	Cross-sectional study. Telephone survey	Adults general population	1,964	Health care system	Medium
Blyth et al^Citation12	Cross-sectional study. Telephone survey	Chronic pain patients aged ≥18 years	484	Work, disability	High
Langley et al^Citation13	Cross-sectional study. Internet survey	Adult general population	5,039	Quality of life, health care system	Medium
Langleyet al^Citation14	Cross-sectional study. Internet survey	Adult general population	5,039	Work	Medium
Smith et al^Citation15	Cross-sectional survey	General population aged over 25 years	3,605	Physical activity	Medium
Nakamura et al^Citation72	Cross-sectional study. Internet survey	Adult general population aged ≥18 years	11,507	Activities of daily living, quality of life, and social relations	Low
Dansie and Turk^Citation16	Narrative review	–	–	Physical activities, quality of life	–
Lerman et al^Citation18	Longitudinal study	Adult chronic pain patients	428	Disability	Medium
Azevedo et al^Citation19	Cross-sectional nationwide study	Adult general population aged ≥18 years	5,094	Disability, work	High
Jones et al^Citation20	Cross-sectional study. Internet survey	Women with fibromyalgia aged 31–78 years	1,735	Activities of daily living, physical activities	Medium
McBeth et al^Citation21	Prospective population-based cohort study	Chronic widespread pain patients aged 25–65 years	3,315	Physical activity, quality of life	Medium
Amris et al^Citation22	Cross-sectional study	Adult women with chronic widespread pain	257	Activities of daily living	High
Rivera and Gonzalez^Citation42	Validation study	Women with fibromyalgia aged 18–65 years	102	Physical activity, work	Medium
Boonen et al^Citation23	Follow-up study, randomized trials	Adults with fibromyalgia, chronic low back pain, or ankylosing spondylitis	291	Health care system, costs	High
Donmez et al^Citation73	Experimental, intervention	Adult women with fibromyalgia	30	Physical activity, work	Low
van Weering et al^Citation24	Cross-sectional study	Chronic low back pain patients aged 18–65 years	52	Activities of daily living	Medium
Stewart et al^Citation25	Cross-sectional study	Working adult patients with pain	28,902	Work	High
Gerstle et al^Citation74	Descriptive correlational research	Adults with chronic nonmalignant pain	36	Quality of life	Low
Carmona et al^Citation26	Observational survey	General population aged ≥20 years	2,192	Physical activity, quality of life, health care system and social relations	High
Campos and Vazquez^Citation27	Cross-sectional study	Adult women with fibromyalgia	76	Quality of life	Medium
Lopez-Silva et al^Citation28	Cross-sectional study	Primary care patients aged >18 years	170	Quality of life, work, costs	Low
Garcia-Campayo et al^Citation29	Cross-sectional nationwide study	Primary care patients	1,150	Quality of life, health care system	High
Davies et al^Citation30	Cross-sectional study	Adult population	269	Quality of life	Medium
Tuzun^Citation31	Narrative review	–	–	Quality of life, work, family	–
O’Brien et al^Citation32	Prospective study	Female with chronic pain	22	Sleep	Medium
Quartana et al^Citation33	Cross-lagged panel analysis	Adult patients with temporomandibular joint disorders	53	Sleep	High
Català et al^Citation34	Epidemiological observational population-based cross-sectional study	Adult general population ≥18 years	5,000	Activities of daily living	Medium
Kovacs et al^Citation35	Longitudinal/cohort study	Workers patients with low back pain	165	Work, disability, quality of life	Medium
Ubago Linares et al^Citation36	Cross-sectional survey	Fibromyalgia patients	214	Work, physical activity	Medium
Patel et al^Citation37	Systematic review of observational studies	–	–	Work	–
Breivik et al^Citation38	Review	–	–	Health care system, quality of life, work physical activity	–
Tornero et al^Citation39	Cross-sectional	Working population	6,264	Work, costs	Medium
Liedberg and Henriksson^Citation75	Qualitative study, interviews	Adult women with fibromyalgia	39	Work	Low
Costa-Black et al^Citation40	Review	–	–	Work	–
Watson et al^Citation41	Follow-up study	Working population	2,291	Work, costs	Medium
Sicras-Mainar et al^Citation43	Cross-sectional study	Fibromyalgia patients	1,081	Health care system, costs	High
Salido et al^Citation76	Cross-sectional study	Adult women with fibromyalgia	51	Work	Low
Collado et al^Citation44	Epidemiological study	Fibromyalgia patients aged 16–64 years	325	Family, work	High
McCluskey et al^Citation45	Qualitative study, interviews	Claimants and significant others	–	Family	Low
Porter et al^Citation46	Cross-sectional study	Patients with osteoarthritis and their partners	38	Family	Low
Moulin et al^Citation47	Observational survey	Adult general population	2,012	Family, work, social relations	Medium
Hill et al^Citation48	Observational survey	General population aged ≥15 years	3,001	Quality of life	Medium
Tuzun et al^Citation49	Cross-sectional study	Fibromyalgia patients, myofascial pain syndrome patients, and controls	99	Quality of life	Medium
Henwood and Ellis^Citation50	Qualitative study, focus groups	Adult patients with chronic neuropathic pain	24	Physical activities, activities of daily living	Low
da Cruz et al^Citation51	Cross-sectional study	Caregivers of patients with chronic pain	30	Family	Low
Bigatti and Cronan^Citation52	Cross-sectional study	Spouses of fibromyalgia patients and spouses of controls	288	Family, quality of life, health care system	Medium
Neumann and Buskila^Citation77	Cross-sectional study	Relatives of fibromyalgia women and relatives of controls	118/124	Family, quality of life, physical activities	Low
Söderberg et al^Citation78	Qualitative study, interviews	Husband of fibromyalgia patients	5	Family	Low
Miller and Cano^Citation53	Observational survey	Adult general population	1,179	Family	High
Ferrell^Citation54	Review	–	–	Family	–
Ferrell et al^Citation55	Quasi-experimental study	Patients with cancer pain and family caregivers	231	Family	Medium
Hinds^Citation79	Qualitative study, interviews	Families of cancer patients	83	Family	Low
Redinbaugh et al^Citation56	Cross-sectional study	Pain patients and caregivers	31	Family, quality of life, activities of daily living	Medium
Yeager et al^Citation57	Cross-sectional study	Cancer patients and caregivers	86	Family	Medium
Miaskowski et al^Citation80	Cross-sectional study	Caregivers of cancer patients and caregivers of pain-free patients	86/42	Family	Medium
Woolf et al^Citation58	Observational survey	Patients with musculoskeletal pain and primary care physicians	5,803/1,483	Quality of life	Medium
Azevedo et al^Citation61	Cross-sectional nationwide study	Adult general population aged ≥18 years	5,094	Health care system	High
Perez et al^Citation62	Observational multicenter study	Patients with chronic peripheral neuropathic pain	1,703	Health care system, costs	High
Levinson et al^Citation63	Observational survey	General population aged ≥21 years	4,859	Health care system	Medium
Blyth et al^Citation64	Observational survey	General population aged ≥16 years	17,543	Health care system	High
Keeley et al^Citation65	Prospective study	Low back patients	108	Quality of life, health care system	Medium
Failde et al^Citation66	Cross-sectional nationwide study	Adult general population aged ≥18 years	1,957	Health care system	High
Dellaroza et al^Citation81	Cross-sectional study	Older patients with chronic pain	1,271	Health care system	Low
Toliver-Sokol et al^Citation67	Cross-sectional study	Pain adolescents (12–18 years) and community adolescents	117	Health care system, physical activity	Medium
Andersson et al^Citation68	Cross-sectional study	General population aged 25–74 years	1,806	Health care system, activities of daily living	Medium
Von Korff et al^Citation69	Cross-sectional study	Pain patients and controls	372	Health care system	Medium
Garcia-Martinez et al^Citation82	Qualitative cross-sectional survey	General Practitioners and managers	96	Health care system	Low
Collantes-Estevez and	Observational multicenter study	Patients with osteoarthritis	2,228	Activities of daily living	Medium
Fernandez-Perez^Citation70
Aguera et al^Citation71	Cross-sectional study	Adult patients with unexplained pain	3,189	Health care system	High

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