Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 5:15:2249-2261.
doi: 10.2147/JPR.S367480. eCollection 2022.

Are Pain Screening and Functional Assessment Results Associated with New Diagnoses and Treatment for Pain in Primary Care? An Observational Study

Affiliations

Are Pain Screening and Functional Assessment Results Associated with New Diagnoses and Treatment for Pain in Primary Care? An Observational Study

Sarah Hudson Scholle et al. J Pain Res. .

Abstract

Purpose: To determine if pain screening and functional assessment results are associated with new diagnoses and treatment for pain in primary care.

Patients and methods: Observational study at 13 primary care sites of a statewide federally qualified health center that implemented routine screening and functional assessment for all adults in primary care. The study group included 10,091 adults aged 18+ who had an in-person visit between July 2, 2018, and June 1, 2019, where they screened positive for chronic pain and completed a 3-question functional assessment with the PEG (Pain, Enjoyment of Life, General Activity). Multivariate logistic regressions quantified associations between pain frequency, diagnosis and treatment, sociodemographics, comorbidities, and self-reported severe pain impairment with pain diagnoses and treatment documented after screening.

Results: Patients were mostly women (60.3%), Latinx (41.1%), English-speaking (80.1%), and Medicaid-insured (62.0%); they averaged 49.1 years old (SD = 13.7 years). Patients with severe pain impairment or who were Latinx were more likely to get a newly documented pain diagnosis (absolute risk difference [ARD]: 13.2% and 8.6%, ps < 0.0001), while patients with mental health/substance use or medical comorbidities were less likely (ARDs: -20.0% to -6.2%, ps < 0.001). Factors most consistently associated with treatment were prior treatment of the same modality (4 of 7 treatments, ARDs = 27.3% to 44.1%, ps <0.0001), new pain diagnosis (5 of 7, ARDs = 3.2% to 27.4%, ps <0.001), and severe impairment (4 of 7, ARDs = 2.6% to 6.5%, ps < 0.0001). A new diagnosis had the strongest association with non-opioid pain analgesics and physical medicine (ARD = 27.0% and 27.4%, p < 0.0001). Latinx patients were less likely to receive opioid analgesics and mental health/substance use medications and counseling (ARDs = -3.3% to 7.5%, ps <0.0001).

Conclusion: Screening and assessment with patient-reported tools may influence pain care. Care for Latinx patients differed from non-Latinx white patients.

Keywords: PEG; chronic pain; equity; federally qualified health center; patient-reported outcome measures; primary care.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

References

    1. Dueñas M, Ojeda B, Salazar A, et al. A review of chronic pain impact on patients, their social environment and the health care system. J Pain Res. 2016;9:457–467. doi:10.2147/JPR.S105892 - DOI - PMC - PubMed
    1. Gaskin DJ, Richard P. The economic costs of pain in the United States. J Pain. 2012;13(8):715–724. doi:10.1016/j.jpain.2012.03.009 - DOI - PubMed
    1. Gormsen L, Rosenberg R, Bach FW, et al. Depression, anxiety, health-related quality of life and pain in patients with chronic fibromyalgia and neuropathic pain. Eur J Pain. 2010;14(2):127.e1–8. doi:10.1016/j.ejpain.2009.03.010 - DOI - PubMed
    1. Tunks ER, Weir R, Crook J. Epidemiologic perspective on chronic pain treatment. Can J Psychiatry Rev Can Psychiatr. 2008;53(4):235–242. doi:10.1177/070674370805300404 - DOI - PubMed
    1. Racine M. Chronic pain and suicide risk: a comprehensive review. Prog Neuropsychopharmacol Biol Psychiatry. 2018;87:269–280. doi:10.1016/j.pnpbp.2017.08.020 - DOI - PubMed