Journal article
Rurality impacts pain care for female veterans similarly to male veterans
The Journal of rural health, Vol.39(2), pp.313-319
Spring 2023
DOI: 10.1111/jrh.12646
PMID: 35170073
Abstract
Purpose Rural disparities exist in access to multidisciplinary pain care with higher rates of opioid prescribing in rural regions. Among Veterans, who have prevalent rates of chronic pain, women often evidence complex presentations, multiple comorbidities, and dissatisfaction with care. This study investigates the impact of rurality on pain care for women specifically, and whether this varies from the impact of rurality for men. Methods A cohort of Veterans with chronic pain in 2018 was built utilizing VA administrative data. Variables of interest included: demographic, comorbidities, medications, and health care utilization for chronic pain. Findings The cohort included 2,261,030 Veterans; 11% (n = 248,977) were women. Significantly fewer women (7%) compared to men (10.7%) received long-term opioids (adjusted OR = 0.77, 95% CI: 0.75-0.78). Men, relative to women, were also more likely to receive gabapentinoids and nonsteroidal ant-inflammatory drugs, whereas women, relative to men, were more likely to receive muscle relaxants and duloxetine. Women were more likely to receive most psychiatric medications. Rural women received more primary care visits compared to urban women (adjusted OR = 1.19, 95% CI: 1.15-1.22), but fewer women's clinic visits (a subset of primary care visits: adjusted OR = 0.69, 95% CI:0.67-0.71) and fewer pain specialty care visits (physical therapy, pain clinic, and mental health visits with pain codes). Rural effects did not vary substantially between women and men. Conclusions Rural-dwelling Veterans received more pain and psychiatric medications compared to urban Veterans and fewer specialty care visits. Rural Veterans may benefit from increased access to specialty chronic pain care.
Details
- Title: Subtitle
- Rurality impacts pain care for female veterans similarly to male veterans
- Creators
- Katherine Hadlandsmyth - Iowa City VA Health Care SystemMary A. Driscoll - Yale UniversityJasmine G. Mares - Roy J. and Lucille A. Carver College of MedicineVanessa Au - Iowa City VA Health Care SystemKelly Richardson Miell - Iowa City VA Health Care SystemBrian C. Lund - Iowa City VA Health Care System
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.39(2), pp.313-319
- Publisher
- Wiley
- DOI
- 10.1111/jrh.12646
- PMID
- 35170073
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Number of pages
- 7
- Grant note
- US Department of Veterans Affairs Health Services Research and Development (HSRD) Service; US Department of Veterans Affairs CIN 13-412 / Center for Access and Delivery Research and Evaluation (CADRE) Center 16023 / US Department ofVeterans Affairs (VA) Office of RuralHealth
- Language
- English
- Electronic publication date
- 02/16/2022
- Date published season
- Spring 2023
- Date published
- 2023
- Academic Unit
- Psychiatry; Epidemiology; Anesthesia; Internal Medicine
- Record Identifier
- 9984280865302771
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