Use of non-pharmacological pain treatment modalities among veterans with chronic pain: results from a cross-sectional survey

SN Edmond, WC Becker, MA Driscoll… - Journal of general …, 2018 - Springer
SN Edmond, WC Becker, MA Driscoll, SE Decker, DM Higgins, KM Mattocks, RD Kerns
Journal of general internal medicine, 2018Springer
Background Despite strong evidence for the effectiveness of non-pharmacological pain
treatment modalities (NPMs), little is known about the prevalence or correlates of NPM use.
Objective This study examined rates and correlates of NPM use in a sample of veterans who
served during recent conflicts. Design We examined rates and demographic and clinical
correlates of self-reported NPM use (operationalized as psychological/behavioral therapies,
exercise/movement therapies, and manual therapies). We calculated descriptive statistics …
Background
Despite strong evidence for the effectiveness of non-pharmacological pain treatment modalities (NPMs), little is known about the prevalence or correlates of NPM use.
Objective
This study examined rates and correlates of NPM use in a sample of veterans who served during recent conflicts.
Design
We examined rates and demographic and clinical correlates of self-reported NPM use (operationalized as psychological/behavioral therapies, exercise/movement therapies, and manual therapies). We calculated descriptive statistics and examined bivariate associations and multivariable associations using logistic regression.
Participants
Participants were 460 veterans endorsing pain lasting ≥ 3 months who completed the baseline survey of the Women Veterans Cohort Study (response rate 7.7%.
Main measures
Outcome was self-reported use of NPMs in the past 12 months.
Key results
Veterans were 33.76 years old (SD = 10.72), 56.3% female, and 80.2% White. Regarding NPM use, 22.6% reported using psychological/behavioral, 50.9% used exercise/movement and 51.7% used manual therapies. Veterans with a college degree (vs. no degree; OR = 2.51, 95% CI = 1.46, 4.30, p = 0.001) or those with worse mental health symptoms (OR = 2.88, 95% CI = 2.11, 3.93, p < 0.001) were more likely to use psychological/behavioral therapies. Veterans who were female (OR = 0.63, 95% CI = 0.43, 0.93, p = 0.02) or who used non-opioid pain medications (OR = 1.82, 95% CI = 1.146, 2.84, p = 0.009) were more likely to use exercise/movement therapies. Veterans who were non-White (OR = 0.57, 95% CI = 0.5, 0.94, p = 0.03), with greater educational attainment (OR = 2.11, 95% CI = 1.42, 3.15, p < 0.001), or who used non-opioid pain medication (OR = 1.71, 95% CI = 1.09, 2.68, p = 0.02) were more likely to use manual therapies.
Conclusions
Results identified demographic and clinical characteristics among different NPMs, which may indicate differences in veteran treatment preferences or provider referral patterns. Further study of provider referral patterns and veteran treatment preferences is needed to inform interventions to increase NPM utilization. Research is also need to identify demographic and clinical correlates of clinical outcomes related to NPM use.
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