Abstract
BackgroundPain is highly prevalent among older adults, but little is known about how patient involvement in medical decision-making may play a role in limiting its occurrence or severity. The purpose of this study was to evaluate whether physician-driven and patient-driven participation in decision-making were associated with the odds of frequent and severe pain.MethodsA cross-sectional population-based survey of 3,135 persons age 65 and older was conducted in the 108-county region comprising West Texas. The survey included self-reports of frequent pain and, among those with frequent pain, the severity of pain.ResultsFindings from multivariate logistic regression analyses showed that higher patient-driven participation in decision-making was associated with lower odds (OR, 0.82; 95% CI, 0.75–0.89) of frequent pain, but was not significantly associated with severe pain. Physician-driven participation was not significantly associated with frequent or severe pain.ConclusionsThe findings suggest that patients may need to initiate involvement in medical decision-making to reduce their chances of experiencing frequent pain. Changes to other modifiable health care characteristics, including access to a personal doctor and health insurance coverage, may be more conducive to limiting the risk of severe pain.
Highlights
Pain is highly prevalent among older adults, but little is known about how patient involvement in medical decision-making may play a role in limiting its occurrence or severity
But tenure with a personal doctor was associated with frequent pain
Frequent pain was more common among persons with more comorbid diseases or conditions, those with arthritis, and those with poorer self-rated general health
Summary
Pain is highly prevalent among older adults, but little is known about how patient involvement in medical decision-making may play a role in limiting its occurrence or severity. The purpose of this study was to evaluate whether physician-driven and patient-driven participation in decision-making were associated with the odds of frequent and severe pain. As the number of elderly persons in the United States rises, more research is needed to determine how the delivery of medical care could be altered to limit the onset of pain and its subsequent burden on health status and the health care system. Several studies suggest that patients, especially those with chronic conditions, who have opportunities to participate in care have more positive health outcomes than those who do not [6,7].
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