Health-related quality of life and pain interference in two patient cohorts with neuropathic pain: breast cancer survivors and HIV patients

Abstract

Abstract Objectives Persistent pain is common in HIV patients and breast cancer (BC) survivors. The aim of this study was to compare two patient groups with neuropathic pain (NP) regarding several psychological variables and Health-related Quality of Life. Although, treatment of pain is always planned individually, the knowledge of the differences and similarities between the patient groups may help us to understand more precisely the targets of the interventions for pain. Methods Eighty nine BC and 73 HIV patients with symptoms of neuropathic pain (patients with ≥3/7 in the Douleur Neuropathique four interview part (DN4i)) participated in a cross-sectional study. Patients completed questionnaires about mood (HADS), symptoms of insomnia (ISI), pain catastrophizing (PCS), personality (TIPI), Mental and Physical Health-related Quality of Life (M/PHrQoL, RAND/SF-36), and pain intensity and interference (BPI). Analyses were applied by using t-tests and linear regression to assess associations between the studied factors. Results HIV patients reported higher anxiety (p<0.001), depressive symptoms (p<0.001), pain catastrophizing (p<0.001) and pain interference (p<0.001), poorer sleep (p<0.001), and lower HrQoL in all dimensions compared with BC survivors. There were significant differences in personality traits extraversion, emotional stability, and agreeableness between the two patient groups. In HIV patients, pain interference (β=−0.344, p<0.001) and mood (β=−0.580, p<0.001) and in the BC group, mood (β=−0.591, p<0.001), extraversion (β=0.229, p=0.005) and sleep (β=−0.154, p=0.042) associated with MHrQoL. Pain interference (HIV β=−0.645, p<0.001, BC β=−0.491, p<0.001) and age (HIV β=−0.016, p=0.042 and BC β=−0.018, p=0.019) associated with PHrQoL in both groups, and catastrophizing in the BC group (β=−0.303, p<0.001). Conclusions HIV patients and BC survivors with neuropathic pain, measured with DN4i, have significant differences in various health-related variables and Health-related Quality of Life with both patient groups reporting low HrQoL. The differences in low HrQoL may reflect the fundamental differences between these diseases, BC survivors in remission and HIV patients living with a chronic disease that is under control. This study brings information about the diversity of different patient populations with symptoms of neuropathic pain, and how neuropathic pain associates with wide range of health-related factors. Interventions to support better coping with the symptoms of neuropathic pain could be tailored more individually if the background disease is taken into account.