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The association of persistent pain with out-patient addiction treatment outcomes and service utilization.

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  • المؤلفون: Caldeiro RM;Caldeiro RM; Malte CA; Calsyn DA; Baer JS; Nichol P; Kivlahan DR; Saxon AJ
  • المصدر:
    Addiction (Abingdon, England) [Addiction] 2008 Dec; Vol. 103 (12), pp. 1996-2005. Date of Electronic Publication: 2008 Oct 08.
  • نوع النشر :
    Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, Non-P.H.S.
  • اللغة:
    English
  • معلومة اضافية
    • المصدر:
      Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9304118 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1360-0443 (Electronic) Linking ISSN: 09652140 NLM ISO Abbreviation: Addiction Subsets: MEDLINE
    • بيانات النشر:
      Publication: Oxford : Wiley-Blackwell
      Original Publication: Abingdon, Oxfordshire, UK : Carfax Pub. Co., c1993-
    • الموضوع:
      Pain/*complications ; Substance Abuse Treatment Centers/*statistics & numerical data ; Substance-Related Disorders/*rehabilitation; Adult ; Female ; Humans ; Male ; Middle Aged ; Outpatient Clinics, Hospital ; Pain/epidemiology ; Pain/psychology ; Pain Measurement ; Patient Compliance/psychology ; Prevalence ; Prospective Studies ; Substance-Related Disorders/complications ; Treatment Outcome ; Veterans
    • نبذة مختصرة :
      Aims: To estimate the prevalence of persistent pain among veterans in out-patient addiction treatment and examine associated addiction treatment outcomes and medical and psychiatric service use.
      Design, Setting and Participants: Analysis of data from a prospective randomized controlled trial comparing on-site versus referral primary care of veterans with substance dependence (n = 582), excluding opioid dependence who had at least one follow-up interview during the 12-month study period in a Veterans Affairs (VA) out-patient addiction treatment center.
      Measurements: Pain status was classified as persistent (pain was rated moderate to very severe at all time-points), low (pain was rated none to mild at all time-points) or intermittent (all others). Main outcome measures were addiction treatment retention, addiction severity index (ASI) alcohol and drug composite scores, VA service utilization and treatment costs.
      Findings: A total of 33.2% of veterans reported persistent pain and 47.3% reported intermittent pain. All groups benefited from addiction treatment, but veterans with persistent pain were in treatment for an estimated 35.1 fewer days [95% confidence interval (CI) = -64.1, -6.1, P = 0.018], less likely to be abstinent from alcohol or drugs at 12 months [odds ratio (OR)(adj) = 0.52; 95% CI = 0.30,0.89; P = 0.018], had worse ASI alcohol composite scores at 12 months (beta(adj) = 0.09; 95% CI = 0.02,0.15; P = 0.007), were more likely to be medically hospitalized (OR(adj) = 2.70; 95% CI = 1.02,7.13; P = 0.046) and had higher total service costs compared to those with low pain ($17 766 versus $13 261, P = 0.012).
      Conclusions: Persistent pain is common among veterans in out-patient addiction treatment and is associated with poorer rates of abstinence, worse alcohol use severity and greater service utilization and costs than those with low pain.
    • Comments:
      Comment in: Addiction. 2008 Dec;103(12):2006-7. (PMID: 19469744)
    • Molecular Sequence:
      ClinicalTrials.gov NCT00057096
    • الموضوع:
      Date Created: 20081016 Date Completed: 20091002 Latest Revision: 20181201
    • الموضوع:
      20240628
    • الرقم المعرف:
      10.1111/j.1360-0443.2008.02358.x
    • الرقم المعرف:
      18855809