A secondary analysis of how changes in pain interference relate to changes in health-related quality of life and physical function in heart failure

BACKGROUND: High pain interference is common in heart failure (HF), yet its longitudinal relationship with changing physical function and health-related quality of life (HRQoL) remains unclear. OBJECTIVES: Evaluate the relationship between changes in pain interference with changes in: 1) physical function; and 2) HRQoL. METHODS: In this secondary analysis, data were used from the MEMOIR-HF trial, involving 240 participants assessed at baseline, and at 10 weeks, 4 months, and 8 months after baseline. Pain interference was measured using the Health Utilities Index Mark-3, physical function with the Timed Up and Go test, and HRQoL with the Minnesota Living with Heart Failure Questionnaire. Zero-order correlations and linear mixed models were conducted to evaluate the relationship between changes in pain interference with changes in physical function and HRQoL, adjusting for age, gender, race, intervention group, body mass index, HF severity, cardiovascular comorbidities, depression, and sleep. RESULTS: Mean age was 66.59 (SD 11.84) years. Gender was 44.6% men, 55.4% women. Self-reported race was 85.0% White, 13.8% Black, and 1.2% Other. From baseline to 8 months, improvements in pain interference were significantly correlated with an improvement with both physical function and HRQoL. In linear mixed models, improvements in pain interference were associated with improvements in both physical function (F = 0.33, p =.038) and HRQoL (F = 1.62, p =.003). CONCLUSIONS: Findings supported a relationship between changes in pain interference with changes in physical function and HRQoL in HF. Further research is needed with clearly defined chronic pain and more robust pain interference measures.