The following is a summary of “Predictors of Unrelieved Symptoms in All of Us Research Program Participants With Chronic Conditions” published in the December 2022 issue of Pain and Symptom Management by Dreisbach et al.

A chronic ailment has been identified in more than 50% of American adults, and the frequency of numerous chronic disorders is rising. These people were more likely to experience symptom clusters or unrelieved, co-occurring symptoms. For a study, researchers sought to recognize the symptom phenotypes that patients with four common chronic illnesses, especially cancer, chronic obstructive pulmonary disease, heart failure, and/or type 2 diabetes mellitus, exhibit and to comprehend the variables that influence membership in symptomatic phenotypes.

They used participant replies (N=14,127) to survey questions from the All of Us Research Program, a biological database maintained by the National Institutes of Health. They employed hierarchical clustering to create symptom phenotypes for tiredness, emotional distress, and pain. They next used multinomial regression to see if demographic, healthcare access and use, and health-related factors might predict symptom phenotype.

Three very symptomatic phenotypes (marked by severe symptoms, severe pain, and severe emotional distress) and one asymptomatic or slightly symptomatic phenotype were found. As there were more chronic diseases, a greater proportion of patients fit the severe symptoms profile. The likelihood of having a highly symptomatic phenotype was most significantly raised by postponing or forgoing medical care and evaluating one’s mental health as poor or fair.

They discovered significant associations between demographic, health-related, and symptom phenotype- and access-related parameters. Understanding the causes of unrelieved symptoms was crucial given the rising numbers of American adults who have one or more chronic illnesses and the desire for individualized care in the era of precision health.