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Published on: April 14, 2016
Latent Classes of Pain Treatment Utilization at a Tertiary Pain Clinic: A Cross-Sectional Study
Dokyoung S You1, Troy C Dildine2, Edward Lannon2
1TSET Health Promotion Research Center-Tulsa/Stephenson Cancer Center, Dept. of Family and Community Medicine, University of Oklahoma Health Sciences, 4502 E. 41st Street, Tulsa, OK, 74135, O: 918-660-3923.
Background:
Chronic pain, particularly high-impact chronic pain (HICP), poses substantial health burdens for older adults. Multimodal and multidisciplinary treatments (MMT) are recommended for chronic pain, yet their utilization across age and HICP status remains unclear. This study examined current treatment utilization patterns and associated health status among younger (< 65) and older (≥ 65) adults, with and without HICP, at a tertiary pain clinic.
Methods:
Cross-sectional data (N = 347; 34% older adults; 57% HICP) were analyzed. HICP was defined using the Graded Chronic Pain Scale-Revised. Health status was assessed using PROMIS measures. Latent class analysis identified treatment utilization subgroups. Logistic regression examined whether age, HICP, or their interaction predicted group membership. One-way ANOVAs compared health status across classes.
Results:
Three treatment patterns emerged: Class 1 (60%), primarily using non-opioid medication; Class 2 (29%), primarily using opioid medication; and Class 3 (11%), utilizing MMT (movement-based therapy, pain psychology, and other modalities). Older age and HICP were associated with an increased likelihood of Class 2 membership, but not with Class 3 membership. The age by HICP interaction was not significant. Compared to Class 1, Class 2 reported worse pain, pain interference, and physical function, while Class 3 reported greater pain interference, fatigue, and psychosocial distress.
Conclusion:
MMT uptake was low and unrelated to age or HICP status. Patients using MMT exhibited greater symptom burden, suggesting that those with complex presentations are more likely to engage in MMT. Longitudinal studies are needed to determine whether MMT reduces symptom burden over time.

