Identifying Predictors of Recommendations for and Participation in Multimodal Nonpharmacological Treatments for Chronic Pain Using Patient-Reported Outcomes and Electronic Medical Records
| Autor: | Di Zhang, Anna E Bartman, Cheryl D. Bernstein, Andrea G. Gillman, Jong-Hyeon Jeong, Ajay D. Wasan |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Logistic regression 03 medical and health sciences 0302 clinical medicine Pharmacotherapy medicine Electronic Health Records Humans Combined Modality Therapy Patient Reported Outcome Measures 030212 general & internal medicine Patient participation Rehabilitation business.industry Medical record Chronic pain Retrospective cohort study General Medicine medicine.disease Analgesics Opioid Anesthesiology and Pain Medicine Physical therapy Female Neurology (clinical) Chronic Pain business 030217 neurology & neurosurgery |
| Zdroj: | Pain Medicine. 21:3574-3584 |
| ISSN: | 1526-4637 1526-2375 |
| Popis: | Objective High-quality chronic pain care emphasizes multimodal treatments that include medication and nonpharmacological treatments. But it is not clear which patients will participate in nonpharmacological treatments, such as physical therapy or mental health care, and previous research has shown conflicting evidence. Methods We used the Patient Outcomes Repository for Treatment (PORT) registry, which combines patient-reported outcomes data with electronic medical records. In this retrospective observational study, we performed two separate multinomial regression analyses with feature selection to identify PORT variables that were predictive of 1) recommendation of a nonpharmacological treatment by the provider and 2) patient participation in nonpharmacological treatments. Two hundred thirty-six patients were recommended (REC) or not recommended (NO REC) a nonpharmacological treatment, and all REC patients were classified as participating (YES) or not participating (NO) in the recommendations. Results Female gender and a diagnosis of Z79 “Opioid drug therapy” were significant positive and negative predictors of nonpharmacological treatment recommendations, respectively. Schedule II opioid use at initial presentation and recommendations for rehabilitation therapy were significant predictors of nonparticipation. Conclusions Patients using opioids are less likely to be recommended nonpharmacological treatments as part of multimodal chronic pain care and are less likely to participate in nonpharmacological treatments once recommended. Males are also less likely to be recommended nonpharmacological treatments. Patients referred for rehabilitation therapies are less likely to comply with those recommendations. We have identified patients in vulnerable subgroups who may require additional resources and/or encouragement to comply with multimodal chronic pain treatment recommendations. |
| Databáze: | OpenAIRE |
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