Henry Ford Health, Behavioral Health Services.
Henry Ford Health, Center for Health Policy and Health Services Research.
Clin J Pain. 2024 Feb 1;40(2):67-71. doi: 10.1097/AJP.0000000000001165.
Engagement in evidence-based psychological interventions for pain management is low. Identifying characteristics associated with interest in interventions can inform approaches to increase uptake and engagement. The purpose of this study was to examine factors associated with interest in psychological interventions among persons with chronic noncancer pain receiving prescription opioids.
Participants with chronic noncancer pain and a new 30 to 90 day opioid prescription were recruited from 2 health systems. Participants (N=845) completed measures regarding pain, opioid use, psychiatric symptoms, emotional support, and interest in psychological interventions for pain management.
There were 245 (29.0%) participants who reported a high interest in psychological interventions for pain management. In bivariate analyses, variables associated with interest included younger age, female sex, greater pain severity, greater pain interference, greater number of pain sites, lower emotional support, depression, anxiety, and post-traumatic stress disorder ( P <0.05). In a multivariate model, greater pain severity (odds ratio [OR]=1.17; CI: 1.04-1.32), depression (OR=2.10; CI: 1.39-3.16), post-traumatic stress disorder (OR=1.85; CI: 1.19-2.95), and lower emotional support (OR=0.69; CI: 0.5-0.97) remained statistically significant.
The rate of interest in psychological interventions for pain management was low, which may indicate that patients initiating opioid treatment of chronic noncancer pain have low interest in psychological interventions. Greater pain severity and psychiatric distress were related to interest, and patients with these characteristics may especially benefit from psychological interventions. Providers may want to refer to psychological interventions before or when opioids are initiated. Additional work is needed to determine whether this would reduce long-term opioid use.
参与基于证据的疼痛管理心理干预的比例较低。确定与干预措施兴趣相关的特征可以为增加接受度和参与度的方法提供信息。本研究的目的是调查接受处方阿片类药物治疗慢性非癌性疼痛的患者对心理干预措施感兴趣的相关因素。
从 2 个医疗系统招募慢性非癌性疼痛且新开出 30 至 90 天阿片类药物处方的患者。参与者（N=845）完成了有关疼痛、阿片类药物使用、精神症状、情感支持以及对疼痛管理的心理干预措施的兴趣的量表。
有 245 名（29.0%）参与者报告对疼痛管理的心理干预措施有很高的兴趣。在单变量分析中，与兴趣相关的变量包括年龄较小、女性、疼痛程度更严重、疼痛干扰更大、疼痛部位更多、情感支持较少、抑郁、焦虑和创伤后应激障碍（P<0.05）。在多变量模型中，疼痛程度更严重（比值比[OR]=1.17；置信区间[CI]：1.04-1.32）、抑郁（OR=2.10；CI：1.39-3.16）、创伤后应激障碍（OR=1.85；CI：1.19-2.95）和情感支持较低（OR=0.69；CI：0.5-0.97）仍然具有统计学意义。
对疼痛管理的心理干预措施的兴趣率较低，这可能表明开始阿片类药物治疗慢性非癌性疼痛的患者对心理干预措施的兴趣较低。疼痛程度更严重和精神疾病更严重与兴趣相关，具有这些特征的患者可能特别受益于心理干预措施。医生可能希望在开阿片类药物之前或同时转介心理干预措施。需要进一步的工作来确定这是否会减少长期阿片类药物的使用。
