OBJECTIVE: Despite a growing number of women seeking medical care in the veterans affairs (VA) system, little is known about the characteristics of their chronic pain or the pain care they receive. This study sought to determine if sex differences are present in the medical care veterans received for chronic pain. DESIGN: Retrospective cohort study using VA administrative data. SUBJECTS: The subjects were 17,583 veteran patients with moderate to severe chronic non-cancer pain treated in the Pacific Northwest during 2008. METHODS: Multivariate logistic regression assessed for sex differences in primary care utilization, prescription of chronic opioid therapy, visits to emergency departments for a pain-related diagnosis, and physical therapy referral. RESULTS: Compared with male veterans, female veterans were more often diagnosed with two or more pain conditions, and had more of the following pain-related diagnoses: fibromyalgia, low back pain, inflammatory bowel disease, migraine headache, neck or joint pain, and arthritis. After adjustment for demographic characteristics, pain diagnoses, mental health diagnoses, substance use disorders, and medical comorbidity, women had lower odds of being prescribed chronic opioid therapy (adjusted OR [AOR] 0.67, 95% CI 0.58-0.78), greater odds of visiting an emergency department for a pain-related complaint (AOR 1.40, 95% CI 1.18-1.65), and greater odds of receiving physical therapy (AOR 1.19, 95% CI 1.05-1.33). Primary care utilization was not significantly different between sexes. CONCLUSIONS: Sex differences are present in the care female veterans receive for chronic pain. Further research is necessary to understand the etiology of the observed differences and their associations with clinical outcomes. Wiley Periodicals, Inc.
OBJECTIVE: Despite a growing number of women seeking medical care in the veterans affairs (VA) system, little is known about the characteristics of their chronic pain or the pain care they receive. This study sought to determine if sex differences are present in the medical care veterans received for chronic pain. DESIGN: Retrospective cohort study using VA administrative data. SUBJECTS: The subjects were 17,583 veteran patients with moderate to severe chronic non-cancer pain treated in the Pacific Northwest during 2008. METHODS: Multivariate logistic regression assessed for sex differences in primary care utilization, prescription of chronic opioid therapy, visits to emergency departments for a pain-related diagnosis, and physical therapy referral. RESULTS: Compared with male veterans, female veterans were more often diagnosed with two or more pain conditions, and had more of the following pain-related diagnoses: fibromyalgia, low back pain, inflammatory bowel disease, migraine headache, neck or joint pain, and arthritis. After adjustment for demographic characteristics, pain diagnoses, mental health diagnoses, substance use disorders, and medical comorbidity, women had lower odds of being prescribed chronic opioid therapy (adjusted OR [AOR] 0.67, 95% CI 0.58-0.78), greater odds of visiting an emergency department for a pain-related complaint (AOR 1.40, 95% CI 1.18-1.65), and greater odds of receiving physical therapy (AOR 1.19, 95% CI 1.05-1.33). Primary care utilization was not significantly different between sexes. CONCLUSIONS: Sex differences are present in the care female veterans receive for chronic pain. Further research is necessary to understand the etiology of the observed differences and their associations with clinical outcomes. Wiley Periodicals, Inc.
Entities:
Keywords:
Chronic Opioid Therapy; Chronic Pain; Sex Differences; Veteran Women
Authors: Charles S Cleeland; Cielito C Reyes-Gibby; Marie Schall; Kevin Nolan; Judith Paice; Jack M Rosenberg; Jane H Tollett; Robert D Kerns Journal: Clin J Pain Date: 2003 Sep-Oct Impact factor: 3.442
Authors: Amabile B Dario; Manuela L Ferreira; Kathryn Refshauge; Juan F Sánchez-Romera; Alejandro Luque-Suarez; John L Hopper; Juan R Ordoñana; Paulo H Ferreira Journal: Eur Spine J Date: 2015-06-18 Impact factor: 3.134
Authors: Erica R Scioli-Salter; Brian N Smith; Savannah McSheffrey; Matthew J Bair; Marie A Sillice; Mary Driscoll; Diana M Higgins; Kelly Allsup; Aneline Amalathas; Megan R Gerber Journal: Am J Lifestyle Med Date: 2017-12-12
Authors: Ammar Siddiqui; Laura Belland; Laura Rivera-Reyes; Daniel Handel; Kabir Yadav; Kennon Heard; Amanda Eisenberg; Ula Hwang Journal: Med Care Date: 2015-11 Impact factor: 2.983
Authors: Joanne Salas; Jeffrey F Scherrer; Brian K Ahmedani; Laurel A Copeland; Kathleen K Bucholz; Mark D Sullivan; Thomas Burroughs; F David Schneider; Patrick J Lustman Journal: J Pain Date: 2017-10-10 Impact factor: 5.820
Authors: Hilary J Mosher; Lan Jiang; Mary S Vaughan Sarrazin; Peter Cram; Peter J Kaboli; Mark W Vander Weg Journal: J Hosp Med Date: 2013-12-06 Impact factor: 2.960
Authors: Elisheva R Danan; Erin E Krebs; Kristine Ensrud; Eva Koeller; Roderick MacDonald; Tina Velasquez; Nancy Greer; Timothy J Wilt Journal: J Gen Intern Med Date: 2017-09-14 Impact factor: 5.128