Pain in vulnerable people with chronic conditions: a multicentric cross-sectional study

Background: Pain is a subjective, multidimensional experience modulated by emotional states and mental processes. It may be a source of major alterations in quality of life, and it represents substantial costs for health care systems and society. Objectives: This research aims at exploring, in vulnerable persons living with chronic conditions, the relation between pain intensity and: (1) socio-demographic variables; (2) sedentary behaviour and physical exercise and (3) quality of life. Design: The EFFICHRONIC intervention is part of the Third EU Health Programme. It consisted of implementing the Chronic Disease Self-Management Programme in five European regions (in France, Italy, Spain, the Netherlands and the United Kingdom). Methods: Adjusting for a wide range of variables in multivariable regressions and using multiple imputation methods, we examined the associations between the intensity of pain and the other variables of interest in a large sample (1364 participants). Results: These analyses showed that women had more intense pain, as well as participants with a lower education level. The pain was, among all variables, the main predictor of sleep problems, fatigue, depression, self-perceived health and quality of life. Conclusion: Our results confirmed the importance of the social component in the complex aetiology of pain, and reinforced the idea that the recognition of the social determinants of health is essential. They are also in line with other studies showing the major impact of pain on an individual’s health and life. Decreasing social inequalities and vulnerability could clearly reduce the prevalence of pain. Trial registration: The study was registered at ISRCTN – The UK’s Clinical Study Registry (70517103).