Health Care Utilization for Chronic Pain in Low-Income Settings

Newman, Andrea K.; Kapoor, Shweta; Thorn, Beverly E.

doi:10.1093/pm/pny119

Cited by 20 publications

(29 citation statements)

References 57 publications

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“…Sum scores on the Downs and Black checklist ranged between 8/16 and 15/16 (mean: 12.3/16) for cross-sectional studies (n = 47) [ 7 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 ], 10/18 and 17/18 (mean: 12.5/18) for observational cohort studies (n = 26) [ 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 ,…”

Section: Resultsmentioning

confidence: 99%

“…Univariate analyses showed inconsistent findings for the association between catastrophizing and pain medication use (3 reporting a positive association [ 55 , 118 , 126 ] and 3 no association [ 54 , 55 ]—50%) and consultations with healthcare providers (4 reporting a positive association [ 74 , 123 , 126 ], 2 a negative [ 61 , 128 ] and 3 no association [ 54 , 98 ]—44%) in people with pain. For the latter, multivariate analyses showed absence of a direct relationship (7 analyses showing no association [ 25 , 61 , 74 , 123 , 126 ]—0%). Furthermore, no relationship was found between level of catastrophizing and the amount of emergency care used by people experiencing pain (both univariate and multivariate: 4 analyses reporting no association [ 97 ]—0%).…”

Section: Resultsmentioning

confidence: 99%

“…In people experiencing pain, a positive association was found between level of general anxiety symptoms (4 analyses showing a positive association [94,121] and 2 no association [122,130]-67% agreement for a relationship) and depressive symptoms (8 analyses showing a positive association [86,94,96,121,122] and 3 no association [61,74,130]-73%) and using opioids based on univariate analyses. However, for depressive symptoms, multivariate analyses indicated the absence of an association with opioid use (2 analyses showing a positive association [86,101] and 4 no association [62,86,101,121]-33%).…”

Section: Associations Between Cef and Type Of Hcu In People Experiencmentioning

confidence: 99%

“…Kapoor (2014) [61] 1 1 1 NA 1 1 1 NA 1 1 1 NA NA NA 1 NA 1 NA 1 0 NA NA NA NA 1 0 0 12/16 Kratz (2018) [62] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 12/16 Lee (2008) [63] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 1 14/16 Lozier (2018) [64] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 13/16 Macfarlane (1999) [65] 1 1 NA 1 1 1 NA 0 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 1 0 13/16 Macfarlane (2003) [66] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 13/16 Mann (2017) [67] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 13/16 Mannion (2013) [68] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 12/16 McCracken (1997) [69] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 0 NA 1 NA 1 1 NA NA NA NA 1 0 0 12 /16 McCracken (2007) [70] 1 1 1 NA 1 1 1 NA 0 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 12/16 Mourad (2016) [72] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 1 0 14/16 Mourad (2018) [71] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 0 1 0 13/16 Ndao-Brumblay (2010) [73] 1 1 1 NA 1 1 1 NA 0 1 0 NA NA NA 1 NA 1 NA 0 0 NA NA NA NA 1 0 0 10/16 Newman (2018) [74] 1 1 1 NA 1 1 1 NA 1 0 0 NA NA NA 1 NA 1 NA 1 0 NA NA NA NA 1 0 0 11/16 Nielsen (2015) [75] 1 1 1 NA 1 1 1 NA 0 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 12/16 Pierce (2019) [76] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 0 NA NA NA NA 1 0 0 12/16 Rosenberg (2008) [77] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 13/16 Shmagel (2016) [78] 1 0 1 NA 1 1 1 NA 1 1 1 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 13/16 Talley (1998) [79] 1 1 1 NA 1 1 1 NA 1 1 1 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 14/16 Thorstensson (2009) [80] 1 1 1 NA 1 1 1 NA 0 1 1 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 1 0 14/16 Torrance (2013) [81] 1 1 1 NA 1 1 1 NA 1 1 1 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 0 0 0 13/16 Tr...…”

Section: Appendix Cmentioning

confidence: 99%

See 3 more Smart Citations

The Relationship between Cognitive and Emotional Factors and Healthcare and Medication Use in People Experiencing Pain: A Systematic Review

Huysmans

Leemans

Beckwée

et al. 2020

JCM

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Pain conditions are among the leading causes of global disability, impacting on global healthcare utilization (HCU). Health seeking behavior might be influenced by cognitive and emotional factors (CEF), which can be tackled by specific therapies. The purpose of this study was to systematically review the evidence concerning associations between CEF and HCU in people experiencing pain. Three databases were consulted: PubMed, Web of Science and EconLit. Risk of bias was assessed using the Downs and Black Checklist (modified). A total of 90 publications (total sample n = 59,719) was included after double-blind screening. In people experiencing pain, positive associations between general anxiety symptoms, depressive symptoms and catastrophizing and pain medication use were found. Additionally, there appears to be a relationship between general anxiety and depressive symptoms and opioid use. Symptom-related anxiety and psychological distress were found to be positively related with consulting behavior. Last, a positive association between use of complementary and alternative medicine and level of perceived symptom control was confirmed in people with pain. For other relationships no evidence or inconsistent findings were found, or they were insufficiently studied to draw firm conclusions, indicating that more research on this topic is needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Associations Between Cef and Type Of Hcu In People Experiencmentioning

confidence: 99%

Section: Appendix Cmentioning

confidence: 99%

See 2 more Smart Citations

The Relationship between Cognitive and Emotional Factors and Healthcare and Medication Use in People Experiencing Pain: A Systematic Review

Huysmans

Leemans

Beckwée

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…On the other hand, not all patients worldwide have access to the same options [105][106][107][108]. Economic issues can make some neurostimulative or implantable pump techniques unaffordable that might be advisable in a patient [109][110][111]. Nevertheless, some of the old surgical ablative procedures might be affordable [87,112] as they have a much lower monetary cost [110] and may be beneficial for these patients.…”

Section: Future Trendsmentioning

confidence: 99%

Where We Come From and Are We Aware of Where We Are Going To?

Vanaclocha¹,

Saiz-Sapena²,

Ortiz-Criado³

et al. 2021

Chronic Pain - Physiopathology and Treatment

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Chronic pain is a pathological condition that requests specific medical attention. Its treatment has been imperative since the origin of our species, taking advantage of herbs and natural remedies available in the primitive environment. Morphine has stood the test of time as has been continuously used for the past 8 millennia. The anatomical knowledge of the nociceptive sensation pathways led to the introduction of some surgical techniques directed to stop this pain transmission. Due to their aggressiveness and to the fact that they are irreversible, these techniques were soon replaced by neurostimulation procedures. Being reversible and allowing a change in stimulation parameters soon became the preferred treatment strategy. Over the years a small subset of patients continues to suffer from chronic pain refractory to the usual neurostimulation and pain-controlling medications. These patients can perhaps benefit from one of the surgical ablative procedures. Some of these techniques have been proven particularly effective throughout the years. For some limited income patients in underdeveloped countries, these techniques may be their only accessible option. Doctors have to keep in mind these surgical techniques to put them at the service of our patients in the very few cases in which they are needed. Letting these ablative techniques to die in oblivion would be a disservice to our patients.

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Socioeconomic risk factors for long‐term opioid use: A national registry‐linkage study

Nestvold,

Skurtveit,

Hamina

et al. 2023

European Journal of Pain

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BackgroundOpioid use has increased substantially as a treatment for chronic pain, although harms from long‐term opioid therapy outweigh the benefits. More knowledge about factors associated with long‐term opioid use is needed. We aimed to investigate the association between socioeconomic status and long‐term opioid use in the period 2010–2019.MethodsThis was a nested case–control study in which the cases were all persons ≥18 years with long‐term opioid use, that is use of opioids for more than 3 months (N = 215,642). Cases were matched on gender, age and index year (first long‐term use period) with four controls who filled at least one opioid prescription, but never developed long‐term opioid use in the study period (N = 862,568). We performed a logistic regression analysis adjusted for relevant confounders, stratified on age groups (18–67 years and 68 years and above).ResultsIn the younger age group, long‐term opioid use was associated with low education (adjusted odds ratio, aOR = 1.54; 95% confidence interval, CI [1.51–1.57]), low income (1.33 [1.31–1.36]), being unemployed (1.40 [1.38–1.42]) and receiving disability pension (1.36 [1.33–1.38]). Weaker associations were found for living in a single‐person household or in a dense geographical area. Similar associations were found for the older age group.ConclusionWe found that low socioeconomic status was associated with long‐term opioid use both among people in working age and older people. These results indicate a need for social and financial support for non‐pharmacological treatment of chronic pain among people with lower socioeconomic status.SignificanceThis study shows that people with low socioeconomic status are at higher risk of developing long‐term opioid use. In the clinical setting, physicians should consider socioeconomic status when prescribing opioids for chronic pain. Non‐pharmacological treatment options funded by public health services should be prioritized to those with low socioeconomic status as long‐term opioid use in chronic pain patients is not recommended.

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Health Care Utilization for Chronic Pain in Low-Income Settings

Abstract: Depressive symptoms are an essential aspect of increased health care use. Study findings support the need for a biopsychosocial approach to chronic pain management.

Cited by 20 publications

References 57 publications

The Relationship between Cognitive and Emotional Factors and Healthcare and Medication Use in People Experiencing Pain: A Systematic Review

The Relationship between Cognitive and Emotional Factors and Healthcare and Medication Use in People Experiencing Pain: A Systematic Review

Where We Come From and Are We Aware of Where We Are Going To?

Socioeconomic risk factors for long‐term opioid use: A national registry‐linkage study

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