Pain and Function in Home Care: A Need for Treatment Tailoring to Reduce Disparities?

Clin J Pain. 2017 Apr;33(4):300-309. doi: 10.1097/AJP.0000000000000410.

Abstract

Objectives: To describe racial/ethnic group differences in pain presentation and the prevalence of psychosocial factors among patients admitted to home health care, and to determine the extent of racial/ethnic group differences in the association of psychosocial factors with pain intensity and pain-related disability.

Methods: We analyzed cross-sectional data on 588 patients with activity-limiting pain admitted to home care for physical therapy. Three psychosocial factors were assessed: depressive symptoms, pain self-efficacy, and health literacy. Statistical methods included estimation of general linear models of pain intensity and pain-related disability.

Results: Hispanics and non-Hispanic blacks report a greater number of pain sites, worse pain intensity, and higher levels of pain-related disability than non-Hispanic whites and others. Racial/ethnic minority group patients also have a higher prevalence of adverse psychosocial factors than others, with evidence that race/ethnicity interacts with pain self-efficacy and depressive symptoms in their association with mean pain intensity and pain-related disability, respectively.

Discussion: The substantial racial/ethnic difference in the psychosocial profiles of older adults with activity-limiting pain highlights the importance of screening for these modifiable risk factors and tailoring interventions accordingly. Direct attention to the psychosocial needs of patients could help to address racial/ethnic disparities in pain outcomes.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Depression / ethnology
  • Disability Evaluation
  • Female
  • Healthcare Disparities / ethnology*
  • Home Care Services*
  • Humans
  • Male
  • Pain / ethnology*
  • Pain / psychology
  • Pain Management
  • Physical Therapy Modalities*
  • Prevalence
  • Prospective Studies
  • Self Efficacy