There is increasing concern among primary care practitioners (PCPs) regarding medication misuse and noncompliance while attempting to effectively manage chronic pain patients prescribed opioids for pain. The aim of this study was to investigate the effect pain catastrophizing has on self-reported pain intensity, disability, side effects, and opioid misuse in chronic pain patients prescribed opioids within primary care. Fifty-six PCPs and 253 chronic pain patients prescribed opioids or considered for opioid therapy were recruited into the study. All patients completed baseline measures, including the Pain Catastrophizing Scale (PCS) and were followed for 6 months to monitor pain and opioid compliance. Patients were divided evenly based on median-split scores on the PCS and participated in phone interviews at 1 and 6 months. The subjects repeated the baseline measures and completed measures of opioid compliance at the end of the study period. Patients who scored high on catastrophizing reported significantly greater pain intensity, activity interference, negative affect, and a higher percentage of medication-related adverse effects compared with those lower on the Pain Catastrophizing Scale at the start of the study and over a 6-month period (p < .01). In addition, those chronic pain patients classified as high pain catastrophizers reported significantly higher opioid misuse (p < .01). This study demonstrates the important role of pain catastrophizing among chronic pain patients who are prescribed opioid medication for pain within primary care. These findings support the benefits of carefully monitoring patients who are prescribed opioids in primary care and possible benefits of offering interventions to reduce pain catastrophizing.

中文翻译：

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灾难化对初级保健疼痛患者疼痛强度、残疾、副作用和阿片类药物滥用的影响

初级保健从业者 (PCP) 越来越担心药物滥用和不依从，同时试图有效管理因疼痛而开出阿片类药物的慢性疼痛患者。本研究的目的是调查疼痛灾难化对在初级保健中使用阿片类药物的慢性疼痛患者自我报告的疼痛强度、残疾、副作用和阿片类药物滥用的影响。该研究招募了 56 名 PCP 和 253 名服用阿片类药物或考虑接受阿片类药物治疗的慢性疼痛患者。所有患者都完成了基线测量，包括疼痛灾难化量表 (PCS)，并随访 6 个月以监测疼痛和阿片类药物依从性。根据 PCS 的中位数分割分数将患者平均分配，并在 1 个月和 6 个月时参加电话采访。在研究期结束时，受试者重复基线测量并完成阿片类药物依从性测量。与在研究开始时和超过 6 个月期间疼痛灾难化量表得分较低的患者相比，灾难化评分高的患者报告的疼痛强度、活动干扰、负面影响和药物相关不良反应的百分比显着更高(p < .01)。此外，那些被归类为高度疼痛灾难者的慢性疼痛患者报告的阿片类药物滥用率明显更高（p < .01）。这项研究证明了在初级保健中使用阿片类药物治疗疼痛的慢性疼痛患者中疼痛灾难化的重要作用。