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Patient Concerns Hamper Rheumatoid Arthritis Pain Control

Rheumatoid arthritis patients leery of pain medications even when pain is moderate-to-severe

WEDNESDAY, March 25 (HealthDay News) -- Many rheumatoid arthritis patients are reluctant to take pain medications and tolerate more pain than necessary as a result, researchers report in the March issue of the Journal of Pain.

Mary-Ann Fitzcharles, M.D., of McGill University in Montreal, Quebec, Canada, and colleagues surveyed 60 consecutive patients with rheumatoid arthritis pain. Functional status was measured with the Health Assessment Questionnaire, and severity of pain was assessed using a Likert scale, a 10-cm visual analog scale and the self-administered McGill Pain Questionnaire. Among the questions, patients were queried about potential barriers to their use of pain medications.

Thirty-two patients (53 percent) reported their pain to be moderate-to-severe and 28 (47 percent) classified it as mild-to-absent, the researchers report. Among barriers to pain control cited were: fear of medication side effects (80 percent), aversion to "too many pills" (63 percent), worry about drug interactions (57 percent), fear of drug addiction (35 percent) and concern about masking disease (27 percent). On average, the patients reported 2.6 barriers to treatment, and 55 percent of patients reported three or more barriers. Sixty-five percent of patients said they were satisfied with current pain control, including nearly half of those who reported moderate-to-severe pain, the authors note.

"Findings of the present study support the concept that barriers to pain control may play an important role in the suboptimal management of pain. Pain relief is traditionally achieved by pharmacological treatments, which were mostly viewed unfavorably by our patients," Fitzcharles and colleagues write.

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