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Distinct groupings of people with HIV and pain associate differently with pain-related healthcare use and health-related quality-of-life (HRQoL): findings from the Pharmacokinetic and Clinical Observations in People Over Fifty (POPPY) study
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EACS 2021 Oct 27-30
Pdf poster attached
Download the PDF here
C. Sabin1,2, R. Harding3, M. Sachikonye4, A. Geressu1, P. Mallon5, F. Post6, M. Boffito7, J. Vera8, I. Williams1, M. Johnson9, J. Anderson10, M. Durkina11, A. Winston12
1UCL, Institute for Global Health, London, United Kingdom, 2National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Blood-Borne and Sexually Transmitted Infections at UCL, London, United Kingdom, 3Kings College London, Cicely Saunders Institute, London, United Kingdom, 4UK Community Advisory Board (UK-CAB), London, United Kingdom, 5University College Dublin, HIV Molecular Research Group, Dublin, Ireland, 6King's College Hospital, Caldecot Centre, London, United Kingdom, 7Chelsea and Westminster Hospital, St. Stephen's Centre, London, United Kingdom, 8Brighton and Sussex University Hospital, Elton John Centre, Brighton, United Kingdom, 9Royal Free Hospital, Ian Charleson Day Centre, London, United Kingdom, 10Homerton University Hospital, Centre for the Study of Sexual Health and HIV, London, United Kingdom, 11Imperial Clinical Trials Unit, London, United Kingdom, 12Imperial College London, Department of Infectious Diseases, London, United Kingdom
abstract
Purpose or Objective
Widespread pain is reported frequently in people with HIV (PWH) and is associated with poor HRQoL. Little is known about the patterns of pain that may be present. We investigated pain profiles and their associations with pain-related healthcare use and patient-reported outcomes among PWH.
Results
Pain information was collected during the baseline POPPY visit (2013-2015) through a self-completed mannikin identifying pain at fifteen body sites. Latent class analysis was used to identify pain profiles which were linked to demographics, existing pain measures (including the Fibromyalgia definition of widespread pain), pain-related healthcare use, depressive symptoms (CES-D, PHQ-9) and HRQoL (SF-36), using Chi-squared and Kruskal-Wallace tests.
Materials and Methods
Among 683 PWH (86.8% male, 87.9% white, median age 57 (inter-quartile range 47-59) years), four pain profiles were identified. Group 1 (57.3% of cohort) was characterised by low rates of pain at all body sites; Group 2 (18.3%) was characterised primarily by high rates of back pain; Group 3 (15.2%) was characterised by high rates of pain at the joints, but not back pain; Group 4 (9.2%) reported high rates of pain at all sites. There were few demographic differences between groups, but those in Groups 3 and 4 were most likely to have poor educational attainment and to be unemployed (p=0.005 and p=0.0001, respectively). Whilst 88.9% of those in Group 4 also met the Fibromyalgia criteria for widespread pain, this was only met by 10.4% and 21.2% of those in Groups 2 and 3, respectively, and none of those in Group 1 (p=0.0001). Pain-related healthcare use, depressive symptoms and HRQoL all increased progressively through Groups 1-4 (Table)
Conclusion
Our findings identify distinct pain profiles with different associations with healthcare resource use, depressive symptoms and HRQoL emphasising the need for targeted approaches to assess and manage pain in PWH.
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