OPIOID PAIN MEDICATION PRESCRIPTION FOR CHRONIC PAIN IN PRIMARY CARE CENTERS: THE ROLES OF PAIN ACCEPTANCE, PAIN INTENSITY, DEPRESSIVE SYMPTOMS, PAIN CATASTROPHIZING, SEX AND AGE
Although evidence suggests that a number of patient psychological factors may influence physicians’ decisions about prescribing opioid analgesics, few studies have sought to identify these factors. The current study aims to (1) identify the individual factors that discriminate between those patients with chronic pain who have from those who have not been prescribed opioid-pain medication for pain management in a sample of 675 patients from a primary care setting and then (2) determine which of these make significant and independent contributions to the prediction of opioid prescribing when controlling for the other factors. The variables examined in the current study were patient sex, age, pain intensity, depressive symptoms, pain catastrophizing and pain acceptance. Although no differences were found between men and women, individuals with chronic non-cancer pain who were given an opioid prescription were older, reported higher levels of pain intensity and depressive symptoms, and reported lower levels of pain-acceptance that individuals who were not given an opioid prescription. Pain intensity and depressive symptoms were independently associated with opioid prescribing when the other predictors were controlled. The findings suggest the possibility that patient factors– in particular their pain intensity and depressive symptom severity – influence physician prescribing, even when it might not be appropriate for these factors to play such a role. If the findings are replicated in other samples, they would suggest that it might be useful for primary care physicians to be aware of the potential biasing impact of these factors on their decisions about treatment.