اپیدمیولوژی درد مزمن در شهر تهران و برآورد کوچک ناحیه‌ای شیوع آن در محله‌های تهران، با استفاده از رویکرد بیزی (مطالعه Urban HEART-2)

Background & Objectives: Chronic pain is one of main public and individual health problems and its epidemiological understanding needs reliable estimates of prevalence. The aim of this study was to investigate the epidemiology of chronic pain in all 368 neighborhoods of Tehran using small area estimation method. Methods: The pain section from the second round of Urban HEART data from a selected individual of 23457 households in Tehran using a multistage randomized cluster sampling in 2011, were analyzed. In order to obtain reliable estimates for chronic pain prevalence at neighborhood level, a generalized linear mixed model and hierarchical Bayesian approach were used and the reliability of the estimates were evaluated. Results: The average of estimated prevalence of chronic pain in neighborhoods of Tehran was 25.5% and a large heterogeneity was observed in its prevalence in neighborhoods of Tehran. Prevalence of chronic pain was significantly higher in married housewives, retirees and pensioners and was significantly associated with age, educational status, depression and anxiety (P<0.05). The reliability of Bayesian method was confirmed by evaluation methods in this analysis. Conclusion: These results demonstrate prevailing amount of chronic pain at neighborhood-level in Tehran, which warrants careful attention to prevention, treatment, and rehabilitation by health care professionals.