Chronic pain and pain medication use in chronic obstructive pulmonary disease. A cross-sectional study

Ann Am Thorac Soc. 2013 Aug;10(4):290-8. doi: 10.1513/AnnalsATS.201303-040OC.


Rationale: Pain is a common problem for patients with chronic obstructive pulmonary disease (COPD). However, pain is minimally discussed in COPD management guidelines.

Objectives: The objective of this study was to describe chronic pain prevalence among patients with COPD compared with similar patients with other chronic diseases in a managed care population in the southwestern United States (age ≥ 40 yr).

Methods: Using data for the period January 1, 2006 through December 31, 2010, patients with COPD were matched to two control subjects without COPD but with another chronic illness based on age, sex, insurance, and healthcare encounter type. Odds ratios (OR) for evidence of chronic pain were estimated using conditional logistic regression. Pulmonary function data for 200 randomly selected patients with COPD were abstracted.

Measurements and main results: Retrospectively analyzed recurrent pain-related utilization (diagnoses and treatment) was considered evidence of chronic pain. The study sample comprised 7,952 patients with COPD (mean age, 69 yr; 42% male) and 15,904 patients with other chronic diseases (non-COPD). Patients with COPD compared with non-COPD patients had a higher percentage of chronic pain (59.8 vs. 51.7%; P < 0.001), chronic use of pain-related medications (41.2 vs. 31.5%; P < 0.001), and chronic use of short-acting (24.2 vs. 15.1%; P < 0.001) and long-acting opioids (4.4 vs. 1.9%; P < 0.001) compared with non-COPD patients. In conditional logistic regression models, adjusting for age, sex, Hispanic ethnicity, and comorbidities, patients with COPD had higher odds of chronic pain (OR, 1.56; 95% confidence interval [CI], 1.43-1.71), chronic use of pain-related medications (OR, 1.60; 95% CI, 1.46-1.74), and chronic use of short-acting or long-acting opioids (OR, 1.74; 95% CI, 1.57-1.92).

Conclusions: Chronic pain and opioid use are prevalent among adults with COPD. This finding was not explained by the burden of comorbidity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analgesics, Opioid / therapeutic use
  • Arthritis / epidemiology
  • Case-Control Studies
  • Chronic Pain / drug therapy
  • Chronic Pain / epidemiology*
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology
  • Female
  • Heart Failure / epidemiology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Myocardial Ischemia / epidemiology
  • Neoplasms / epidemiology
  • Odds Ratio
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Renal Insufficiency, Chronic / epidemiology
  • Retrospective Studies
  • Stroke / epidemiology


  • Analgesics, Opioid