Measurement of the Global Mental Health in Subjects With COPD and Chronic Pain

Abstract

PURPOSE: The use of global health items permits an efficient way of gathering general perceptions of health, thereby providing useful summary information about health and predicting health care utilization and subsequent mortality. However, research on the effect of anxiety and depression (AD) and chronic non-cancer pain (CNCP) on health care utilization, which can be measured by health-related quality of life measures (HQROL), is scarce. The objective is to measure AD of subjects with COPD and CNCP using the PROMIS-57v1.0, a health related quality of life (HRQOL) measure., METHODS: A retrospective cross-sectional study was done in a Comprehensive Outpatient Rehabilitation Facility on 77 individuals with COPD (mean age 68 years, range age 57-75, 45 men, 32 women), identified as those afflicted with CNCP via the Self-Administered Co-Morbidity Questionnaire. The PROMIS-57v1.0 Anxiety & Depression subscales measured Global Mental Health (GMH). Physical performance status (PPS) via Berg Balance Scale (BBS) was also tested., RESULTS: Fifty-five percent of individuals with COPD identified CNCP. Anxiety T-scores had a range 43.2 - 83.1 and average 62.23, while Depression T-scores ranged 38.2 - 81.3 with average 60.15. BBS scores averaged 43.6/56 and sub-categorized as: 9% poor balance, 24% fair, and 67% good balance., CONCLUSIONS: The study found that both dimensions AD, which underlie as separate GMH items in PROMIS, comprise a common co-occurring clinical entity, albeit mild, in adults with COPD & CNCP and tend to influence their PPS. These global health scales can efficiently summarize mental health in patient-reported outcome studies and even in a busy clinical practice. Further study on the correlation of PROMIS-AD and PPS scores in COPD should be done., CLINICAL IMPLICATIONS: Pain co-morbidity influences the functional performance of individuals with COPD and manifests as mild anxiety and depression, therefore requiring routine clinical pain assessment in these subjects., DISCLOSURE: The following authors have nothing to disclose: Armando Miciano, No Product/Research Disclosure Information, Copyright (C) 2011 by the American College of Chest Physicians