Association between levels of functional disability and health-related quality of life with spinal cord stimulation for chronic pain

Taylor, R. S. , Soliday, N., Leitner, A., Hunter, C. W., Staats, P. S., Li, S., Thomson, S., Kallewaard, J. W., Russo, M. and Duarte, R. V. (2022) Association between levels of functional disability and health-related quality of life with spinal cord stimulation for chronic pain. Neuromodulation, (doi: 10.1016/j.neurom.2022.04.039) (PMID:35643846) (Early Online Publication)

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Abstract

Objectives: Pain score, functional disability, and health-related quality of life (HRQoL) are core outcome domains for chronic pain clinical trials. Although greater levels of pain reduction have been shown to be linked to larger gains in HRQoL, little is known of the association between HRQoL and disability in the setting of chronic pain. The aims of this study were to 1) investigate the association between functional disability and HRQoL and 2) estimate the utility values associated with levels of functional disability in patients treated with evoked compound action potential (ECAP) spinal cord stimulation (SCS) for chronic pain. Materials and Methods: Data on functional disability assessed using the Oswestry Disability Index (ODI) and HRQoL (EQ-5D-5L) were collected from 204 patients with an Evoke ECAP-SCS device and followed up to 12 months. SF-6D utility scores also were retrieved for 134 of these patients. Multivariable linear regression models adjusted for baseline utility values and patient demographics were used to compare differences in utility values across ODI categories. Results: Significant improvements in functional disability and HRQoL were observed at three- and 12-month follow-up after SCS. Patients reporting “minimum disability,” “moderate disability,” “severe disability,” and “crippled” had mean EQ-5D scores of 0.82, 0.73, 0.59, and 0.45, respectively. The mean change in EQ-5D score was 0.007 per unit change in total ODI score. The R2 statistic showed a moderate level association (49%–64% of variance in EQ-5D explained by ODI). Conclusion: ECAP-SCS results in significant improvements in functional disability and HRQoL. This study shows that improvement in function of people with chronic pain before and after ECAP-SCS is associated with improvement in HRQoL.

Item Type:Articles
Keywords:Chronic pain, spinal cord stimulation, health-related quality of life, disability
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Taylor, Professor Rod
Authors: Taylor, R. S., Soliday, N., Leitner, A., Hunter, C. W., Staats, P. S., Li, S., Thomson, S., Kallewaard, J. W., Russo, M., and Duarte, R. V.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Neuromodulation
Publisher:Elsevier
ISSN:1094-7159
ISSN (Online):1525-1403
Published Online:26 May 2022

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