Pain self-management: easier said than done? Factors associated with early dropout from pain self-management in a rural primary care population
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Date
2018-09-06
Authors
Hardman, Ruth
Lawn, Sharon Joy
Tsourtos, George
Journal Title
Journal ISSN
Volume Title
Publisher
Oxford University Press
Rights
© 2018 American Academy of Pain Medicine. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license:
http://creativecommons.org/licenses/by-nc-nd/4.0/
Rights Holder
© 2018 American Academy of Pain Medicine. All rights reserved.
Abstract
Objective
To explore whether psychosocial or demographic factors are associated with early dropout from pain self-management in a rural, low–socioeconomic status population.
Design
Secondary analysis of retrospective data.
Setting
Multidisciplinary pain clinic located in an outer regional area of Australia.Subjects
One hundred eighty-six people attending a public community health center with chronic noncancer pain (mean age 54.9 years; 58.1% women; 81.7% in receipt of government benefit as their primary source of income).
Methods
Bivariate analysis and logistic regression, with early dropout as the dependent variable and a range of demographic and psychological independent variables.
Results
Following bivariate analysis, early dropout was significantly associated (P < 0.05) with male gender, younger age, history of substance use, being a past victim of assault/abuse, receiving unemployment or disability benefit, having literacy difficulties, higher pain catastrophizing score, higher daily opioid dose, and not holding a multifactorial belief about the cause of pain. Logistic regression analysis resulted in three significant predictors of dropout: substance use history (P = 0.002), past victim of assault or abuse (P = 0.029), high pain catastrophising score (P = 0.048); and one of engagement: holding a multifactorial belief about pain cause (P = 0.005).
Conclusions
In a rural, low–socioeconomic status population, addressing social stressors related to lifetime adversity may be important to increasing engagement in pain self-management. Lack of attention to these factors may increase health inequity among those most disabled by chronic pain. Further research into dropout and engagement, especially among disadvantaged populations, is recommended.
Description
This manuscript version is made available under the CC-BY-NC-ND 4.0 license:
http://creativecommons.org/licenses/by-nc-nd/4.0/ which permits use, distribution and reproduction in any medium, provided the original work is properly cited. This author accepted manuscript is made available following 12 month embargo from date of publication (Sept 2018) in accordance with the publisher’s archiving policy
Keywords
Self-Management, Chronic Pain, primary healthcare, social determinants of health
Citation
Hardman, R., Lawn, S. and Tsourtos, G., (2018). Pain self-management: easier said than done? Factors associated with early dropout from pain self-management in a rural primary care population. Pain Medicine, pny 167: doi 10.1093/pm/pny167.