Investigating pain in heart failure patients: The pain assessment, incidence, and nature in heart failure (PAIN-HF) study

Sarah J. Goodlin, Sue Wingate, Nancy M. Albert, Susan J. Pressler, Janet Houser, Jennifer Kwon, Jun Chiong, C. Porter Storey, Timothy Quill, John R. Teerlink

Research output: Contribution to journalArticlepeer-review

85 Scopus citations


Background: Patients with advanced heart failure (HF) have high rates of pain and other symptoms that diminish quality of life. We know little about the characteristics and correlates of pain in patients with advanced HF. Methods and Results: We identified pain prevalence, location, character, severity, frequency, and correlates in 347 outpatients with advanced HF enrolled from hospices and clinics. We evaluated the correlation of pain with HF-related quality of life, mortality, symptoms and health problems, and current treatments for pain. Pain at any site was reported by 293 patients (84.4%), and 138 (39.5%) reported pain at more than one site. The most common site of pain was the legs below the knees (32.3% of subjects). Pain interfered with activity for 70% of patients. Pain was "severe" or "very severe" for 28.6% of subjects with chest pain, and for 38.9% of those with other sites of pain. The only medication reported to provide pain relief was opioids, prescribed for 34.1% of subjects (P =.001). The strongest predictors of pain were degenerative joint disease (DJD) (odds ratio [OR] 14.95, 95% confidence interval [CI] 3.9-56.0; P <.001), other arthritis (OR 2.8, 95% CI 1.20-6.62; P =.017), shortness of breath (OR 3.27, 95% CI 1.47-7.28; P =.004), and angina pectoris (OR 3.38, 95% CI 1.30-8.81; P =.013). Conclusions: Pain occurred at multiple sites in patients with advanced HF. Pain correlated with DJD or other arthritis, shortness of breath, and angina. Only opioid analgesics provided relief of pain. Future research should evaluate the etiology of and interventions to manage pain in patients with HF.

Original languageEnglish (US)
Pages (from-to)776-783
Number of pages8
JournalJournal of Cardiac Failure
Issue number10
StatePublished - Oct 2012
Externally publishedYes


  • Heart failure
  • arthritis shortness of breath
  • opioids
  • pain
  • symptoms

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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