A prospective evaluation of health-related quality of life in Hong Kong Chinese patients with chronic non-cancer pain

S Lee, PP Chen, A Lee, M Ma, CM Wong, T Gin
Department of Anaesthesiology and Operating Services, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong

OBJECTIVE. To evaluate the health-related quality of life in Hong Kong Chinese patients with chronic non-cancer pain.

DESIGN. Prospective cross-sectional survey.

SETTING. Regional public hospitals, Hong Kong.

PATIENTS. Patients attending out-patient pain management clinics between 1 July 2002 and 28 February 2003 were approached to complete a set of standardised questionnaires.

MAIN OUTCOME MEASURES. Demographic profiles, treatment modality, litigation, compensation, social welfare status, Hospital Anxiety Depression Scale, and Medical Outcomes Survey short-form health survey (SF36).

RESULTS. Data from 166 patients were analysed. The median numeric pain rating score was 6 (interquartile range, 2-10). Work-related injury occurred in 34.3% of patients, while another 34% were involved in pain-related litigation and 32% were receiving disability or unemployment benefit. Sixty-four percent of patients were managed by three or more disciplines, while 54.8% were also receiving complimentary alternative medical treatment, mainly traditional Chinese medicine (49.7%). The Hospital Anxiety Depression Score indicated clinical anxiety or depression in 71.1% of patients. All SF36 subscale scores were lower than the local population norm. Unemployed patients had higher depression scores (P=0.005), while students or retirees had lower physical functioning scores (P=0.004). Patients who were single had higher role emotion scores than those who were married or separated/widowed (P=0.011). Logistic regression analysis showed that younger age (odds ratio=0.95), being married (6.62), work-related injury (15.63) or higher general health scores (1.03) were more likely to be associated with litigation. Social welfare benefit was associated with unemployment (3.39) and a lower level of physical functioning (0.98).

CONCLUSION. There was a high prevalence of clinical anxiety, depression, and severe impairment in the health-related quality of life in Hong Kong Chinese patients with chronic non-cancer pain. Specific factors affected the health-related quality of life, likelihood of litigation, and social benefit.

Hong Kong Med J 2005;11:174-80

Key words: Chronic disease; Health surveys; Hong Kong; Pain; Quality of life