SRFP021: Characteristics of Patients with Non-Cancer Pain Who Use Alternative Pain Therapies
Anika Mahavni; Joanne Salas, MPH; Lisa Miller-Matero, PhD; Jeffrey Scherrer, PhD
Context: Chronic pain is among the most common conditions managed in primary care. Understanding factors associated with the use of non-opioid treatments may help clinicians reduce long-term opioid prescribing. While characteristics of patients with non-cancer pain who use physical therapy have been described, less is known about factors associated with the use of alternative therapies like cannabidiol (CBD) and chiropractic care. Objective: To determine whether demographics, pain measures, psychosocial factors, and prescription opioid use differ between patients in four alternative treatment groups: 1) CBD, 2) CBD and chiropractic/physical therapy, 3) chiropractic/physical therapy and 4) no alternative therapy. Study Design: Baseline survey data from a longitudinal cohort study of patients with non-cancer pain. Setting or Dataset: Patients who met eligibility criteria based on screening questions and electronic health record data at Saint Louis University School of Medicine and Henry Ford Health System. Population Studied: Patients 18-70 years of age with non-cancer pain who had a new period of prescription opioid use lasting 30-90 days. Outcome Measures: Type of alternative pain treatment (CBD, CBD and chiropractic/physical therapy, chiropractic/physical therapy, and no alternative therapy). Results: Older age was significantly associated with chiropractic/physical therapy use without CBD. Female gender was most prevalent in the CBD and chiropractic/physical therapy group. African American race was most common among those with no alternative therapies; white race was most common in the CBD and chiropractic/physical therapy group. Patients with more pain sites were more likely to be in the CBD and chiropractic/physical therapy group. Those with a history of depression were most prevalent in the CBD and chiropractic/physical therapy group. A positive VE score was associated with CBD and chiropractic/physical therapy. Sleep impairment was more common among those in the CBD and chiropractic/physical therapy group. Those with CBD use had the lowest prevalence of high emotional support. Expected Outcomes: Younger age, female gender, white race, more pain sites, depression, VE, sleep impairment, and low emotional support characterize patients who use non-opioid treatments. Pain interference and severity are not associated with the type or number of alternative therapies. Evidence of racial disparity in the use of non-opioid treatment suggests barriers to care.
Jack Westfall
jwestfall@aafp.org 11/21/2021Great to see students presenting at NAPCRG. Welcome to the best research family around. Terrific poster and presentation. Thanks for your work.