Associations of demographic variables with treatment of chronic pain in patients with spinal cord injury

Research Objectives: To investigate the disparities in recommendation, usage, and willingness to use interventions for pain in patients with spinal cord injuries (SCI), based on race, insurance status, age, and income.

Design: Survey

Setting: Outpatient SCI clinics in two academic medical centers

Participants: Convenience sample of 276 patients with SCI who were 18-years-of-age or older, English-fluent, not diagnosed with bipolar or psychotic disorders, and able to make their own medical decisions. Participants were 76% female, had an average age of 48.7 years (range 18.1-89.8 years), 78% White, 32.4% privately insured, and 62.5% making less than $50,000 per year.

Interventions: Not applicable

Main Outcome Measures: Secondary analyses of the number of self-reported interventions recommended to the patient by a medical provider, tried by the patient, or that the patient would be willing to try. The hypothesis that these outcomes would vary by race, age, insurance status, and income was generated after data collection.

Results: A greater number of treatments recommended was associated with older age (rho=-0.14, 95%CI: -0.01 to -0.26, p=.04), having private insurance and higher pain interference (R2=.09, p=.006). A greater number of treatments tried was associated with having private insurance (rho=0.17, 95%CI: 0.04 to 0.30, p=.01). Willingness to try more treatments was associated with lower education (rho=-0.14, 95%CI: -0.01 to -0.27, p=.03) and lower income (rho=-0.16, 95%CI: -0.02 to -0.28, p=.02).

Conclusions: These exploratory findings indicate that the number of treatment recommendations provided, number of treatments tried, and willingness to try interventions for pain in the context of SCI are significantly associated with age, insurance type, education, and income but not race.

Author(s) Disclosures: None