Evaluación del dolor en consultas de reumatología españolas: Estudio EVADOR

espanolIntroduccion Las enfermedades reumaticas son la causa mas frecuente de dolor cronico no maligno. En los ultimos anos el dolor y su manejo han cobrado mayor relevancia en reumatologia. Objetivos Establecer la prevalencia y las caracteristicas del dolor asociado a enfermedad reumatica atendido en consultas de reumatologia de nuestro pais, asi como de su tratamiento y la respuesta a este. Metodos Estudio multicentrico observacional con 2 fases, una transversal y otra prospectiva. Se recogieron variables del medico, paciente, dolor y su manejo, comorbilidades, respuesta terapeutica y aspectos psicosociales relacionados. Se analizaron las diferencias entre pacientes nuevos y en revision (PR). Resultados Se incluyeron 34 centros y 1.084 pacientes, 32% pacientes nuevos y 68% PR. En general, el dolor estaba presente en el 86% de los pacientes, era cronico en el 81% y neuropatico en un 12%. El 50% de los pacientes consideraria el dolor aceptable cuando la intensidad en la escala visual numerica fuese ≤ 2. Entre los PR existia mayor percepcion de dolor controlado (65,5% vs. 49,4%) y satisfaccion con el tratamiento (53,3% vs. 35,6%). El 23,5% estaba en tratamiento con opioides en el mes previo. Conclusiones En la ultima decada la prevalencia de dolor en el ambito reumatologico en nuestro pais persiste elevada, aunque ha disminuido. El empleo de opioides, por otra parte, ha aumentado. EnglishIntroduction rheumatic diseases are the most frequent cause of non-malignant chronic pain. In recent years, pain and its management have become more important in rheumatology. Objectives to estimate the prevalence and characteristics of pain associated with rheumatic pathology treated in rheumatology clinics in Spain, as well as their treatment and response to it. Methods Multicentre observational study with two phases (cross-sectional and prospective). Variables were collected from the doctor, patient, pain and its management, comorbidities, therapeutic response and related psychosocial aspects. The differences between de novo (NP) vs follow-up (FP) patients were analyzed. Results 34 centres and 1084 patients were included, 32% NP and 68% FP. Pain was present in 86%, was chronic in 81% and neuropathic in 12% of the surveyed population. Fifty percent of the patients would regard their pain as tolerable if its intensity according to the visual numeric scale (VNS) was ≤ 2. Among the FP it was more frequent to have the perception of controlled pain (65.5% vs 49.4%) and to be satisfied with the treatment (53.3% vs. 35.6%). Of these patients, 23.5% had been treated with opioids in the previous month. Conclusions In the last decade, the prevalence of pain in rheumatology in Spain remains high, although it has diminished. The use of opioids, on the other hand, has increased.