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Research ArticleOriginal Research

Factors Associated with Pain Treatment Satisfaction Among Patients with Chronic Non-Cancer Pain and Substance Use

Leslie W. Suen, Vanessa M. McMahan, Christopher Rowe, Sumeet Bhardwaj, Kelly Knight, Margot B. Kushel, Glenn-Milo Santos and Phillip Coffin
The Journal of the American Board of Family Medicine November 2021, 34 (6) 1082-1095; DOI: https://doi.org/10.3122/jabfm.2021.06.210214
Leslie W. Suen
National Clinician Scholars Program, Philip R. Lee Institute of Health Policy Studies, University of California San Francisco, San Francisco, CA (LWS); San Francisco Veterans Affairs Medical Center, San Francisco, CA (LWS); San Francisco Department of Public Health, San Francisco, CA (VMM, CR, GS, PC); University of Toronto, Department of Family and Community Medicine, Toronto, ON, Canada (SB); Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA (KK); Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA (MBK); Department of Community Health Systems, University of California, San Francisco, San Francisco, CA (GS); Department of Medicine, University of California, San Francisco, San Francisco, CA (PC).
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Vanessa M. McMahan
National Clinician Scholars Program, Philip R. Lee Institute of Health Policy Studies, University of California San Francisco, San Francisco, CA (LWS); San Francisco Veterans Affairs Medical Center, San Francisco, CA (LWS); San Francisco Department of Public Health, San Francisco, CA (VMM, CR, GS, PC); University of Toronto, Department of Family and Community Medicine, Toronto, ON, Canada (SB); Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA (KK); Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA (MBK); Department of Community Health Systems, University of California, San Francisco, San Francisco, CA (GS); Department of Medicine, University of California, San Francisco, San Francisco, CA (PC).
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Christopher Rowe
National Clinician Scholars Program, Philip R. Lee Institute of Health Policy Studies, University of California San Francisco, San Francisco, CA (LWS); San Francisco Veterans Affairs Medical Center, San Francisco, CA (LWS); San Francisco Department of Public Health, San Francisco, CA (VMM, CR, GS, PC); University of Toronto, Department of Family and Community Medicine, Toronto, ON, Canada (SB); Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA (KK); Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA (MBK); Department of Community Health Systems, University of California, San Francisco, San Francisco, CA (GS); Department of Medicine, University of California, San Francisco, San Francisco, CA (PC).
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Sumeet Bhardwaj
National Clinician Scholars Program, Philip R. Lee Institute of Health Policy Studies, University of California San Francisco, San Francisco, CA (LWS); San Francisco Veterans Affairs Medical Center, San Francisco, CA (LWS); San Francisco Department of Public Health, San Francisco, CA (VMM, CR, GS, PC); University of Toronto, Department of Family and Community Medicine, Toronto, ON, Canada (SB); Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA (KK); Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA (MBK); Department of Community Health Systems, University of California, San Francisco, San Francisco, CA (GS); Department of Medicine, University of California, San Francisco, San Francisco, CA (PC).
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Kelly Knight
National Clinician Scholars Program, Philip R. Lee Institute of Health Policy Studies, University of California San Francisco, San Francisco, CA (LWS); San Francisco Veterans Affairs Medical Center, San Francisco, CA (LWS); San Francisco Department of Public Health, San Francisco, CA (VMM, CR, GS, PC); University of Toronto, Department of Family and Community Medicine, Toronto, ON, Canada (SB); Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA (KK); Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA (MBK); Department of Community Health Systems, University of California, San Francisco, San Francisco, CA (GS); Department of Medicine, University of California, San Francisco, San Francisco, CA (PC).
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Margot B. Kushel
National Clinician Scholars Program, Philip R. Lee Institute of Health Policy Studies, University of California San Francisco, San Francisco, CA (LWS); San Francisco Veterans Affairs Medical Center, San Francisco, CA (LWS); San Francisco Department of Public Health, San Francisco, CA (VMM, CR, GS, PC); University of Toronto, Department of Family and Community Medicine, Toronto, ON, Canada (SB); Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA (KK); Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA (MBK); Department of Community Health Systems, University of California, San Francisco, San Francisco, CA (GS); Department of Medicine, University of California, San Francisco, San Francisco, CA (PC).
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Glenn-Milo Santos
National Clinician Scholars Program, Philip R. Lee Institute of Health Policy Studies, University of California San Francisco, San Francisco, CA (LWS); San Francisco Veterans Affairs Medical Center, San Francisco, CA (LWS); San Francisco Department of Public Health, San Francisco, CA (VMM, CR, GS, PC); University of Toronto, Department of Family and Community Medicine, Toronto, ON, Canada (SB); Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA (KK); Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA (MBK); Department of Community Health Systems, University of California, San Francisco, San Francisco, CA (GS); Department of Medicine, University of California, San Francisco, San Francisco, CA (PC).
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Phillip Coffin
National Clinician Scholars Program, Philip R. Lee Institute of Health Policy Studies, University of California San Francisco, San Francisco, CA (LWS); San Francisco Veterans Affairs Medical Center, San Francisco, CA (LWS); San Francisco Department of Public Health, San Francisco, CA (VMM, CR, GS, PC); University of Toronto, Department of Family and Community Medicine, Toronto, ON, Canada (SB); Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA (KK); Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA (MBK); Department of Community Health Systems, University of California, San Francisco, San Francisco, CA (GS); Department of Medicine, University of California, San Francisco, San Francisco, CA (PC).
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Abstract

Introduction: A better understanding of pain treatment satisfaction in patients with chronic noncancer pain (CNCP) and substance use is needed, especially as opioid prescribing policies are changing. We sought to identify factors associated with pain treatment satisfaction in individuals with CNCP on recent opioid therapy and prior or active substance use.

Methods: An exploratory cross-sectional analysis using baseline data from a cohort study of 300 adults with CNCP receiving >20 morphine milligram equivalents of opioids for ≥3 of the preceding 12 months and prior or active substance use. Participants completed interviews, clinical assessments, urine drug screening, and medical chart review.

Results: Participants were predominantly middle-aged (mean age 57.5 years), Black (44%), and cisgender men (60%). One-third (33%) had high, 28% moderate, and 39% low pain treatment satisfaction. Post-traumatic stress disorder (PTSD), tobacco use, past-year opioid discontinuation, and higher average pain scores were associated with lower satisfaction. HIV and prescription cannabis use were associated with higher satisfaction.

Conclusions: The relationship between PTSD and tobacco use with lower satisfaction should be explored to augment pain outcomes. Higher satisfaction among individuals with HIV and prescription cannabis use presents potential research areas to guide CNCP management and reduce reliance on opioid therapies.

  • Chronic Disease
  • Chronic Pain
  • Cross-Sectional Studies
  • Opioids
  • Patient Satisfaction
  • Policy
  • Primary Health Care
  • Prospective Studies
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The Journal of the American Board of Family     Medicine: 34 (6)
The Journal of the American Board of Family Medicine
Vol. 34, Issue 6
November/December 2021
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Factors Associated with Pain Treatment Satisfaction Among Patients with Chronic Non-Cancer Pain and Substance Use
Leslie W. Suen, Vanessa M. McMahan, Christopher Rowe, Sumeet Bhardwaj, Kelly Knight, Margot B. Kushel, Glenn-Milo Santos, Phillip Coffin
The Journal of the American Board of Family Medicine Nov 2021, 34 (6) 1082-1095; DOI: 10.3122/jabfm.2021.06.210214

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Factors Associated with Pain Treatment Satisfaction Among Patients with Chronic Non-Cancer Pain and Substance Use
Leslie W. Suen, Vanessa M. McMahan, Christopher Rowe, Sumeet Bhardwaj, Kelly Knight, Margot B. Kushel, Glenn-Milo Santos, Phillip Coffin
The Journal of the American Board of Family Medicine Nov 2021, 34 (6) 1082-1095; DOI: 10.3122/jabfm.2021.06.210214
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Keywords

  • Chronic Disease
  • Chronic Pain
  • Cross-Sectional Studies
  • Opioids
  • Patient Satisfaction
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