Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 1, 2016
   Pages 13 — 24

Abstract — Association between pain outcomes and race and opioid treatment: Retrospective cohort study of Veterans

Diana J. Burgess, PhD;1–2* Amy A. Gravely, MA;1 David B. Nelson, PhD;1–2 Matthew J. Bair, MD, MS;3 Robert D. Kerns, PhD;4 Diana M. Higgins, PhD;4 Melissa M. Farmer, PhD;5 Melissa R. Partin, PhD1–2

1Center for Chronic Disease Outcomes Research, Minneapolis Department of Veterans Affairs (VA) Health Care System, Minneapolis, MN; 2Department of Medicine, University of Minnesota Medical School, Minneapolis, MN; 3Center for Health Information and Communication, VA Health Services Research & Development, Richard L. Roudebush VA Medical Center, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN; and Regenstrief Institute Inc, Indianapolis, IN; 4VA Connecticut Healthcare System, West Haven, CT; and Yale School of Medicine, New Haven, CT; 5VA Health Services Research and Development Service, Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Sepulveda, CA

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.

Key words:blacks, chronic pain, Department of Veterans Affairs, disparities, opioids, pain outcomes, pain treatment effectiveness, race, survey, Veterans.


View HTML ¦ View PDF ¦ Contents Vol. 53, No.1

This article and any supplementary material should be cited as follows:
Burgess DJ, Gravely AA, Nelson DB, Bair MJ, Kerns RD, Higgins DM, Farmer MM, Partin MR. Association between pain outcomes and race and opioid treatment: Retrospective cohort study of Veterans. J Rehabil Res Dev. 2016;53(1):13–24.
http://dx.doi.org/10.1682/JRRD.2014.10.0252
ORCID: Diana J. Burgess, PhD: 0000-0003-1139-7739; Robert D. Kerns, PhD: 0000-0001-7609-2771; Diana M. Higgins, PhD: 0000-0002-6885-266X
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