Le 14/10/2021 de 09:00 à 11:00

Retour Session


La persistance liée à la réalisation d’une tâche est associée à une consommation réduite d’antalgiques chez les patients avec des douleurs musculo-squelettiques chroniques

François Luthi (Sion, Suisse), Philippe Vuistiner (Sion, Suisse), Cyrille Burrus (Sion, Suisse), Michel Konzelmann (Sion, Suisse), Bertrand Léger (Sion, Suisse)

Objectif : Activity patterns are related to miscellaneous outcomes in chronic pain. Avoidance is related to poor outcomes and perpetuation of pain, but associations are contradictory for the 2 others (pacing and persistence). So far, no studies assessed whether activity patterns are associated with different analgesics consumption.

Matériel/Patients et méthodes : We included 18-60 years old patients, admitted for rehabilitation because of persistent pain and disability after musculoskeletal injury. Medication taken at hospitalization was recorded and classified into three categories (no analgesics, non-opioids, opioids). Activity patterns were measured with the POAM-P subscales: avoidance, pacing, and overdoing, the latter considered a measure of persistence related to the goal of completing a task rather than controlling or avoiding pain (task-related persistence). Logistic regressions were conducted to measure the associations between activity patterns and analgesic consumption.

Résultats : A total of 1'906 patients were included (mean age 44±11 years, men 80%, median duration of pain 12.6 months, mean severity of pain: 4.6/10). 43% of patients did not take any analgesic, 36% took non-opioid drugs, and 21% opioids. Avoidance and pacing were associated with increased consumption of analgesics (no difference between opioids and non-opioids), whereas persistence was associated with reduced consumption. In the multivariate model, only persistence remained associated with reduced analgesic consumption (OR: 0.98; p = 0.002).

Discussion - Conclusion : Task-contingent persistence measured with POAM-P, reduce the odds to take analgesics (2% for each point on persistence scale: 0-40 points) independently of age, gender, pain location, pain and injury severity. Further studies should measure if reinforcement of task-contingent persistence may reduce analgesics consumption.

Mots clés : avoidance, pacing, persistence, pain, rehabilitation

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