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J Pain. 2016 Oct;17(10):1068-1080. doi: 10.1016/j.jpain.2016.06.009. Epub 2016 Jul 1.

United States National Pain Strategy for Population Research: Concepts, Definitions, and Pilot Data.

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Group Health Research Institute, Seattle, Washington. Electronic address:
Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Centers for Disease Control and Prevention, Atlanta, Georgia.
University of Maryland School of Public Health, College Park, Maryland.
Mayo Clinic College of Medicine, Phoenix, Arizona.
Yale University School of Medicine, New Haven, Connecticut.
University of Virginia Health System, Charlottesville, Virginia.
University of Washington School of Dentistry, Seattle, Washington.
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
Department of Psychiatry, St. Louis University School of Medicine, St. Louis, Missouri.
University of Washington School of Medicine, Seattle, Washington.
Chronic Pain Research Alliance, Milwaukee, Wisconsin.
Stanford University School of Medicine, Palo Alto, California.


National Pain Strategy population research objectives include: estimating chronic pain prevalence, studying pain treatment with electronic health care data, and developing metrics to assess progress in reducing chronic pain impact. In this article, the National Pain Strategy Population Research Workgroup reviews concepts relevant to achieving these aims. High-impact chronic pain was defined as persistent pain with substantial restriction of life activities lasting 6 months or more. In pilot work, we tested a brief assessment of high-impact chronic pain, and used electronic health records data to describe pain-related health care. A mail survey of adult health plan enrollees (N = 770) reported that 14% had high-impact chronic pain. Relative to persons with lower-impact chronic pain, those with high-impact chronic pain were more often frequent users of health care for pain, reported lower quality of life, greater pain-related interference with activities, and more often reported pain at multiple anatomic locations. Analyses of health care data (N = 289,464) reported that pain patients had higher health care costs compared with others and that pain services were typically delivered in primary care. These results support the feasibility of developing data on chronic pain through national health interview surveys and large electronic health care databases.


Pilot analyses supported the feasibility of brief chronic pain assessments suitable for national health surveys and use of electronic health care databases to develop data regarding trends in the delivery of pain treatments, costs, and effectiveness. These methods are relevant to achieving the aims of the US National Pain Strategy.


Chronic pain; electronic databases; epidemiology; health services research; prevalence

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