Association between pain outcomes and race and opioid treatment

Retrospective cohort study of Veterans

Diana J. Burgess, Amy A. Gravely, David B. Nelson, Matthew Bair, Robert D. Kerns, Diana M. Higgins, Melissa M. Farmer, Melissa R. Partin

Research output: Contribution to journalArticle

Abstract

We examined whether pain outcomes (pain interference, perceived pain treatment effectiveness) vary by race and then whether opioid use moderates these associations. These analyses are part of a retrospective cohort study among 3,505 black and 46,203 non-Hispanic, white Department of Veterans Affairs (VA) patients with diagnoses of chronic musculoskeletal pain who responded to the 2007 VA Survey of Healthcare Experiences of Patients (SHEP). We used electronic medical record data to identify prescriptions for pharmacologic pain treatments in the year after diagnosis (Pain Diagnosis index visit) and before the SHEP index visit (the visit that made one eligible to complete the SHEP); pain outcomes came from the SHEP. We found no significant associations between race and pain interference or perceived effectiveness of pain treatment. VA patients with opioid prescriptions between the Pain Diagnosis index visit and the SHEP index visit reported greater pain interference on the SHEP than those without opioid prescriptions during that period. Opioid prescriptions were not associated with perceived treatment effectiveness for most patients. Findings raise questions about benefits of opioids for musculoskeletal pain and point to the need for alternative treatments for addressing chronic noncancer pain.

Original languageEnglish (US)
Pages (from-to)13-24
Number of pages12
JournalJournal of Rehabilitation Research and Development
Volume53
Issue number1
DOIs
StatePublished - 2016

Fingerprint

Veterans
Opioid Analgesics
Health Care Surveys
Cohort Studies
Retrospective Studies
Pain
Prescriptions
Therapeutics
Musculoskeletal Pain
Chronic Pain
Electronic Health Records

Keywords

  • Blacks
  • Chronic pain
  • Department of veterans affairs
  • Disparities
  • Opioids
  • Pain outcomes
  • Pain treatment effectiveness
  • Race
  • Survey
  • Veterans

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Association between pain outcomes and race and opioid treatment : Retrospective cohort study of Veterans. / Burgess, Diana J.; Gravely, Amy A.; Nelson, David B.; Bair, Matthew; Kerns, Robert D.; Higgins, Diana M.; Farmer, Melissa M.; Partin, Melissa R.

In: Journal of Rehabilitation Research and Development, Vol. 53, No. 1, 2016, p. 13-24.

Research output: Contribution to journalArticle

Burgess, Diana J. ; Gravely, Amy A. ; Nelson, David B. ; Bair, Matthew ; Kerns, Robert D. ; Higgins, Diana M. ; Farmer, Melissa M. ; Partin, Melissa R. / Association between pain outcomes and race and opioid treatment : Retrospective cohort study of Veterans. In: Journal of Rehabilitation Research and Development. 2016 ; Vol. 53, No. 1. pp. 13-24.
@article{1f4780913d0d4911af57355134b060e2,
title = "Association between pain outcomes and race and opioid treatment: Retrospective cohort study of Veterans",
abstract = "We examined whether pain outcomes (pain interference, perceived pain treatment effectiveness) vary by race and then whether opioid use moderates these associations. These analyses are part of a retrospective cohort study among 3,505 black and 46,203 non-Hispanic, white Department of Veterans Affairs (VA) patients with diagnoses of chronic musculoskeletal pain who responded to the 2007 VA Survey of Healthcare Experiences of Patients (SHEP). We used electronic medical record data to identify prescriptions for pharmacologic pain treatments in the year after diagnosis (Pain Diagnosis index visit) and before the SHEP index visit (the visit that made one eligible to complete the SHEP); pain outcomes came from the SHEP. We found no significant associations between race and pain interference or perceived effectiveness of pain treatment. VA patients with opioid prescriptions between the Pain Diagnosis index visit and the SHEP index visit reported greater pain interference on the SHEP than those without opioid prescriptions during that period. Opioid prescriptions were not associated with perceived treatment effectiveness for most patients. Findings raise questions about benefits of opioids for musculoskeletal pain and point to the need for alternative treatments for addressing chronic noncancer pain.",
keywords = "Blacks, Chronic pain, Department of veterans affairs, Disparities, Opioids, Pain outcomes, Pain treatment effectiveness, Race, Survey, Veterans",
author = "Burgess, {Diana J.} and Gravely, {Amy A.} and Nelson, {David B.} and Matthew Bair and Kerns, {Robert D.} and Higgins, {Diana M.} and Farmer, {Melissa M.} and Partin, {Melissa R.}",
year = "2016",
doi = "10.1682/JRRD.2014.10.0252",
language = "English (US)",
volume = "53",
pages = "13--24",
journal = "Journal of rehabilitation R&D",
issn = "0748-7711",
publisher = "Rehabilitation Research and Development Service",
number = "1",

}

TY - JOUR

T1 - Association between pain outcomes and race and opioid treatment

T2 - Retrospective cohort study of Veterans

AU - Burgess, Diana J.

AU - Gravely, Amy A.

AU - Nelson, David B.

AU - Bair, Matthew

AU - Kerns, Robert D.

AU - Higgins, Diana M.

AU - Farmer, Melissa M.

AU - Partin, Melissa R.

PY - 2016

Y1 - 2016

N2 - We examined whether pain outcomes (pain interference, perceived pain treatment effectiveness) vary by race and then whether opioid use moderates these associations. These analyses are part of a retrospective cohort study among 3,505 black and 46,203 non-Hispanic, white Department of Veterans Affairs (VA) patients with diagnoses of chronic musculoskeletal pain who responded to the 2007 VA Survey of Healthcare Experiences of Patients (SHEP). We used electronic medical record data to identify prescriptions for pharmacologic pain treatments in the year after diagnosis (Pain Diagnosis index visit) and before the SHEP index visit (the visit that made one eligible to complete the SHEP); pain outcomes came from the SHEP. We found no significant associations between race and pain interference or perceived effectiveness of pain treatment. VA patients with opioid prescriptions between the Pain Diagnosis index visit and the SHEP index visit reported greater pain interference on the SHEP than those without opioid prescriptions during that period. Opioid prescriptions were not associated with perceived treatment effectiveness for most patients. Findings raise questions about benefits of opioids for musculoskeletal pain and point to the need for alternative treatments for addressing chronic noncancer pain.

AB - We examined whether pain outcomes (pain interference, perceived pain treatment effectiveness) vary by race and then whether opioid use moderates these associations. These analyses are part of a retrospective cohort study among 3,505 black and 46,203 non-Hispanic, white Department of Veterans Affairs (VA) patients with diagnoses of chronic musculoskeletal pain who responded to the 2007 VA Survey of Healthcare Experiences of Patients (SHEP). We used electronic medical record data to identify prescriptions for pharmacologic pain treatments in the year after diagnosis (Pain Diagnosis index visit) and before the SHEP index visit (the visit that made one eligible to complete the SHEP); pain outcomes came from the SHEP. We found no significant associations between race and pain interference or perceived effectiveness of pain treatment. VA patients with opioid prescriptions between the Pain Diagnosis index visit and the SHEP index visit reported greater pain interference on the SHEP than those without opioid prescriptions during that period. Opioid prescriptions were not associated with perceived treatment effectiveness for most patients. Findings raise questions about benefits of opioids for musculoskeletal pain and point to the need for alternative treatments for addressing chronic noncancer pain.

KW - Blacks

KW - Chronic pain

KW - Department of veterans affairs

KW - Disparities

KW - Opioids

KW - Pain outcomes

KW - Pain treatment effectiveness

KW - Race

KW - Survey

KW - Veterans

UR - http://www.scopus.com/inward/record.url?scp=84957928574&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84957928574&partnerID=8YFLogxK

U2 - 10.1682/JRRD.2014.10.0252

DO - 10.1682/JRRD.2014.10.0252

M3 - Article

VL - 53

SP - 13

EP - 24

JO - Journal of rehabilitation R&D

JF - Journal of rehabilitation R&D

SN - 0748-7711

IS - 1

ER -