Category: Treatment - CBT

Symposium

Healthcare Utilization and Opioid Prescriptions in Low-Income Settings

Friday, November 17
10:15 AM - 11:45 AM
Location: Cobalt 501, Level 5, Cobalt Level

Keywords: Pain | Randomized Controlled Trial | Health Psychology
Presentation Type: Symposium

Chronic pain is burdensome for patients and the healthcare system. Many patients become stymied in a perpetual cycle of unsuccessful attempts to find relief from suffering through frequent health care visits and opioid prescriptions. Especially within low-income populations, the burdens of health care services and pain medications are especially unpleasant due to significant financial costs, barriers to transportation, and high levels of stress. We aimed to examine potential variables associated with health care utilization. As part of the Learning About My Pain (LAMP) trial, a randomized comparative effectiveness study of behavioral interventions (PCORI Contract #941, Beverly Thorn, PI), medical records were analyzed from study participants one year pre-treatment and one year post-treatment. Demographic traits (age, gender, race, poverty status, primary literacy, and education level), psychosocial variables (depressive symptoms and pain catastrophizing), opioid prescription in the past year (yes/no), and pain variables (pain intensity, interference, and disability), were entered stepwise into a multiple regression model to predict health care utilization pre- and post-treatment. Regression analyses suggested that pain catastrophizing (β = .20, p < .01), opioid prescription in the past year (β = .19, p < .01), and race (β = .15, p < .05) were significant predictors of health care utilization over a one-year period prior to treatment, explaining a total of 9.2% of variance. Post-treatment analyses suggested that depressive symptoms (β = .22, p < .001) and poverty status (β= .14, p < .01) were significantly associated with health care utilization over a one-year period post treatment, explaining a total of 6.8% of variance. The findings suggest that psychosocial factors are the primary factors accounting for variance in health care utilization among patients with chronic pain in low-income settings, in which increased pain catastrophizing and depressive symptoms are associated with increased health care utilization. Future analyses will examine potential changes in health care utilization and opioid prescriptions based on condition assignment.

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