Use of Self-management Interventions for Chronic Pain Management: A Comparison between Rural and Nonrural Residents

Abstract

Individuals with chronic pain who live in rural communities often lack access to pain specialists and rely on primary care providers who may be less prepared. Research has indicated that rural residents with chronic pain are more likely to receive an opioid prescription than nonrural residents. Although self-management approaches are available for chronic pain management, it is unclear to what extent rural residents use these interventions. This study compares usage of self-management interventions and opioid-based analgesics for chronic pain management between rural and nonrural residents. This study is a secondary analysis of baseline data from a randomized controlled trial evaluating a telehealth intervention for chronic pain management. Participants, recruited from primary care clinics, were 65 rural residents and 144 nonrural residents with similar demographic characteristics. Differences in the use of self-management interventions, pain intensity, and opioid dose were evaluated between rural and nonrural residents. Rural residents (n = 50, 77%) were less likely to use self-management interventions compared with nonrural residents (n = 133, 92%) (p = .019). Opioids were taken for pain relief by 76% of the rural residents compared with 52% of the nonrural residents. A disparity exists in the use of self-management interventions for chronic pain management by rural residents compared with nonrural residents. Further study is needed to determine if this is related to the lack of access to specialists and/or pain management training of primary care providers. Nurses can play an essential role in addressing this disparity by educating patients about self-management interventions.

Geographical variation in musculoskeletal surgical care in public hospitals in Ireland: a repeated cross-sectional study

“…Unemployment rate was calculated from census data as a proxy for the socioeconomic status of an area, which has been found to influence demand for healthcare 30. The proportion of the population living in urban areas (in towns with populations of 1500 or more) were also calculated from the census25 as this could affect both the availability of services and the ability to manage a chronic pain condition 31…”

Rural, Suburban, and Urban Differences in Chronic Pain and Coping Among Adults in North Carolina: 2018 Behavioral Risk Factor Surveillance System

“…Therefore, addressing geographic disparities in nonmedication and multimodal interdisciplinary treatment of chronic pain by using multiple approaches is critical, including increasing the accessibility of nonmedication treatments in suburban and rural areas, coverage of nonmedication treatment by health insurance programs, and specific interventions for individuals with chronic pain. Regarding accessibility of nonmedication treatments, rural areas often have fewer medical specialists and rely on primary care providers (PCP) for the treatment of pain ( 23 ). Because PCPs typically have minimal education on the treatment of chronic pain ( 24 ), improved training of PCPs in pain management and referring chronic pain patients to other practitioners for nonmedication treatments may be promising options to address geographic disparities.…”

Clinical and cost-effectiveness of a guided internet-based Acceptance and Commitment Therapy to improve chronic pain–related disability in green professions (PACT-A): study protocol of a pragmatic randomised controlled trial

“…26 Moreover, the availability of multidimensional and interdisciplinary therapies is limited. [27][28][29] Thus, alternative and new ways to deliver treatment might be beneficial.…”