The Association Between Chronic Pain, Substance use, and Primary Care Experience Among Veterans with Ongoing or Recent Homelessness Article Swipe
Allyson L. Varley
,
Aerin J. DeRussy
,
Audrey L. Jones
,
April E. Hoge
,
Adam J. Gordon
,
Joshua Richman
,
Kevin R. Riggs
,
Lillian Gelberg
,
Sonya Gabrielian
,
John R. Blosnich
,
Ann Elizabeth Montgomery
,
Evan Carey
,
Stefan G. Kertesz
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1007/s11606-024-09078-x
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1007/s11606-024-09078-x
Background Chronic pain and problematic substance use are prevalent among Veterans with homeless experience (VHE) and may contribute to a challenging primary care experience. Objective To examine the association of chronic pain and problematic substance use with unfavorable primary care experiences among VHE and to explore the association of pain treatment utilization and unfavorable care experiences in VHE with chronic pain. Methods We surveyed VHE ( n = 3039) engaged in homeless-tailored primary care at 29 Veterans Affairs Medical Centers (VAMCs). We assessed unfavorable primary care experiences with four validated Primary Care Quality-Homeless (PCQ-H) scales: multivariable logistic regressions explored associations between unfavorable care experiences for VHE with chronic pain and problematic substance use, chronic pain alone, problematic substance use alone, or neither. We then examined the association between receipt of pain treatments and unfavorable experiences among VHE with chronic pain. Last, we identified PCQ-H items that had the greatest difference in unfavorable response rates between VHE with and without chronic pain. Results The prevalence of unfavorable primary care experience was higher on all four scales for patients reporting chronic pain (with or without problematic substance use) (all p < 0.001), but not for problematic substance use alone, compared to VHE with neither pain nor problematic substance use. In analyses limited to VHE with chronic pain, those on long-term opioids were less likely to report an unfavorable experience (OR = 0.49, 95%CI 0.34–0.69). Receipt of occupational therapy was associated with lower odds of reporting an unfavorable experience (OR = 0.83, 95%CI 0707–0.98). PCQ-H items related to trust, relationships, and provider communication had the greatest differences in dissatisfaction ratings (all p < 0.001). Conclusions Chronic pain is associated with unfavorable primary care experiences among VHE, potentially contributing to poor care outcomes. Strategies are needed to enhance patient-provider trust and communication and increase VHE’s access to effective pain treatments.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1007/s11606-024-09078-x
- OA Status
- hybrid
- References
- 56
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4403421615
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4403421615Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1007/s11606-024-09078-xDigital Object Identifier
- Title
-
The Association Between Chronic Pain, Substance use, and Primary Care Experience Among Veterans with Ongoing or Recent HomelessnessWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-10-15Full publication date if available
- Authors
-
Allyson L. Varley, Aerin J. DeRussy, Audrey L. Jones, April E. Hoge, Adam J. Gordon, Joshua Richman, Kevin R. Riggs, Lillian Gelberg, Sonya Gabrielian, John R. Blosnich, Ann Elizabeth Montgomery, Evan Carey, Stefan G. KerteszList of authors in order
- Landing page
-
https://doi.org/10.1007/s11606-024-09078-xPublisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
-
https://doi.org/10.1007/s11606-024-09078-xDirect OA link when available
- Concepts
-
Medicine, Veterans Affairs, Chronic pain, Odds, Odds ratio, Receipt, Primary care, Logistic regression, Physical therapy, Psychiatry, Family medicine, Internal medicine, Computer science, World Wide WebTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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56Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| publication_date | 2024-10-15 |
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