The effect of gender, opioid use/risk, duration of chronic pain and associated factors on response to medical/procedural intervention in chronic pain patients

Abstract

Although numerous studies have evaluated the correlation of various factors such as age/gender/opioid use on the presence of chronic pain, very few have evaluated whether such factors determine how well a patient will respond to a medical/procedural intervention. In this retrospective study, we evaluated various factors that affected response to intervention and whether the type of intervention (medical vs procedural) affected the degree of response. In a study approved by the University of Arizona IRB, Electronic Medical Records (EMRs) were obtained from the Banner University of Arizona pain clinic. From the 2,980 EMRs of adult patients a total of 371 EMRs with different chronic pain conditions were randomly selected and appropriate variables were extrapolated from the charts. Response to medical/procedural intervention was measured by patient reported outcomes for pain and quality of life measures. Data were analyzed by linear regression. The sampled population had 2:3 male/female ratio was and mean age of 54.5 years. We found that the higher initial pain score, and higher opioid risk score, were negatively associated with response to the intervention. Regardless of initial pain score, females and patients with more than one pain sites were likely to respond to the intervention. Interestingly, duration of pain or amount of the opioids had no effect on the degree of response patients had after the intervention. Finally, patients were likely to respond favorably to a procedural intervention compared to medication alone. Our study points towards numerous factors that may affect response to an intervention offered in a chronic pain clinic and procedural intervention is likely going to result in greater reduction in pain compared to medication alone. Future studies will need to evaluate whether the response varies by the type of pain and type of procedure. National Institute of Health (NIH K08 NS104272).