Monday, October 19, 2015
Grand Ballroom EH (Hyatt Regency St. Louis at the Arch)
Poster Board # PS2-38

Mary-Ellen Hogan, BScPhm, PharmD, MSc1, Nicholas Mitsakakis, MSc PhD2, Vibhuti Shah, MD MSc3, Joel Katz, BA, MA, PhD4, Anna Taddio, BScPhm, MSc, PhD5 and Murray D Krahn, MD, MSc, FRCPC2, (1)Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada, (2)Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, ON, Canada, (3)Institute of Health Policy, Management and Evaluation, University of Toronto, Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada, (4)Department of Psychology, York University, Toronto General Research Institute and Department of Anesthesia and Pain Management, University Health Network, Toronto, ON, Canada, (5)Leslie Dan Faculty of Pharmacy, University of Toronto; Department of Child Health Evaluative Sciences, Pharmacy, Hospital for Sick Children, Toronto, ON, Canada
Purpose:      Almost 1 in 5 adults has chronic pain.  New interventions are being developed to manage this widespread condition and cost-utility analyses of these technologies require robust data.  We aimed to estimate utilities using a population based sample of adults with chronic pain and examine the contribution of several factors.   Methods:    Health Utilities Index Mark 3 (HUI3) values, self-reported race/ethnicity and presence of arthritis, back problems, migraines, heart disease, stroke, diabetes and cancer were obtained from the Ontario survey responses of the Canadian Community Health Survey (CCHS) 2009-10.  The CCHS questions for presence of pain, severity and disability from pain were used to identify and stratify patients with chronic pain.  Income, aggregated diagnosis groups (ADGs, Johns Hopkins ACG system, a measure of comorbidity), age and sex were obtained from linked administrative data.  Ordinary least squares regression was used to investigate the impact of variables on utility.    Results:    A total of 15,901 responses for adults 18 – 64 years of age were available for analysis and 4,116 reported chronic pain.  In the pain cohort, mean age was 48 years (SD 12); 59% were female.  The average number of ADGs was 4.2 (SD 2.9).  People with chronic pain had a mean utility of 0.60, 0.22 points below the overall sample mean (see table).  Increasing income quintile was associated with an increase in utility (p<0.001) as was black race (p < 0.05) (versus Caucasian).  Aboriginal ethnicity was associated with a decrease in utility (p<0.001).   Presence of the following conditions was associated with a decrease in utility:  migraine, back problems, arthritis, suffering from the effects of a stroke, heart disease, diabetes and an additional ADG (all p<0.001).  Age, sex, and having cancer were not significantly associated with utility change.     Conclusions:    Utilities in people with chronic pain were very low and decreased with greater pain and more activity limitations.  A decrement of 0.22 is larger than seen with heart disease, diabetes, COPD, asthma and epilepsy.1  To our knowledge, this study is the first to estimate utilities in patients with chronic pain at the population level.  This data will be useful to inform future cost-utility analyses.   1Mittmann N, Trakas K, Risebrough N, Liu B.  Utility scores for chronic conditions in a community-dwelling population.  Pharmacoeconomics 1999; 15(4):369-376.