2019. Chronic Pain and Self-Management Among Veterans with Diabetes
Sarah L Krein, PhD, RN, VA Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, M Heisler, VA Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, JD Piette, VA Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, F Makki, VA Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, EA Kerr, VA Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System

Objectives: Studies suggest that 30-50% of adults experience chronic pain but little is known about the consequences of such pain in patients with other chronic conditions. We examined the extent to which chronic pain serves as a barrier to performing recommended self-management practices among patients with diabetes.

Methods: 900 VA patients with diabetes receiving care at 25 primary care sites completed a written survey in 2003. Individuals with chronic pain were identified as those reporting pain that was present for at least six months during the prior year. We used bivariate techniques and multivariable regression to identify associations between chronic pain and self-care behaviors.

Results: Sixty percent of survey respondents reported chronic pain, with the majority indicating they had pain in their back and hip or knee. On average, pain interfered with daily activities on 18 out of the last 28 days. Respondents with chronic pain were significantly more likely to report difficulty with taking medications (8% vs. 4%), exercising regularly (73% vs. 42%), following a recommended eating plan (54% vs. 37%), and checking their feet (15% vs. 9%) (all p < .05).

Conclusions: Chronic pain is prevalent among VA patients with diabetes and may limit the performance of self-care behaviors that are important for minimizing diabetes-related complications.

Impact: The presence of competing demands such as chronic pain should be considered when developing self-care regimens for VA patients with diabetes. Future research should also address whether better pain control improves the performance of self-care behaviors such as physical activity.