Where we live matters: a comparison of chronic pain treatment between remote and non-remote regions of Quebec, Canada.

IF 2.5 Q2 CLINICAL NEUROLOGY Frontiers in pain research (Lausanne, Switzerland) Pub Date : 2024-02-26 eCollection Date: 2024-01-01 DOI:10.3389/fpain.2024.1291101
Claudie Audet, Meriem Zerriouh, Hermine Lore Nguena Nguefack, Nancy Julien, M Gabrielle Pagé, Line Guénette, Lucie Blais, Anaïs Lacasse
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Abstract

Objective: Where a person lives is a recognized socioeconomic determinant of health and influences healthcare access. This study aimed to compare the pain treatment profile of persons with chronic pain (CP) living in remote regions to those living in non-remote regions (near or in major urban centers).

Methods: A cross-sectional study was performed among persons living with CP across Quebec. In a web-based questionnaire, participants were asked to report in which of the 17 administrative regions they were living (six considered "remote"). Pain treatment profile was drawn up using seven variables: use of prescribed pain medications, over-the-counter pain medications, non-pharmacological pain treatments, multimodal approach, access to a trusted healthcare professional for pain management, excessive polypharmacy (≥10 medications), and use of cannabis for pain.

Results: 1,399 participants completed the questionnaire (women: 83.4%, mean age: 50 years, living in remote regions: 23.8%). As compared to persons living in remote regions, those living in non-remote regions were more likely to report using prescribed pain medications (83.8% vs. 67.4%), a multimodal approach (81.5% vs. 75.5%), experience excessive polypharmacy (28.1% vs. 19.1%), and report using cannabis for pain (33.1% vs. 20.7%) (bivariable p < 0.05). Only the use of prescribed medications as well as cannabis remained significantly associated with the region of residence in the multivariable models.

Discussion: There are differences in treatment profiles of persons with CP depending on the region they live. Our results highlight the importance of considering remoteness, and not only rurality, when it comes to better understanding the determinants of pain management.

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我们生活的地方很重要:加拿大魁北克偏远地区和非偏远地区慢性疼痛治疗的比较。
目的:一个人的居住地是公认的健康的社会经济决定因素,并影响医疗保健的获得。本研究旨在比较居住在偏远地区的慢性疼痛患者与居住在非偏远地区(靠近或位于主要城市中心)的慢性疼痛患者的疼痛治疗情况:在魁北克省的慢性疼痛患者中开展了一项横断面研究。在一份网络问卷中,参与者被要求报告他们居住在 17 个行政区域中的哪个区域(其中 6 个被视为 "偏远地区")。通过七个变量得出了疼痛治疗概况:使用处方止痛药、非处方止痛药、非药物止痛治疗、多模式方法、获得可信赖的专业医护人员的止痛治疗、过度使用多种药物(≥10 种药物)以及使用大麻止痛:1,399 名参与者填写了问卷(女性:83.4%,平均年龄:50 岁,居住在偏远地区者:23.8%)。与生活在偏远地区的人相比,生活在非偏远地区的人更有可能报告使用处方止痛药(83.8% 对 67.4%)、采用多模式方法(81.5% 对 75.5%)、过度使用多种药物(28.1% 对 19.1%),以及报告使用大麻止痛(33.1% 对 20.7%)(双变量 p 讨论):CP患者的治疗情况因居住地区不同而存在差异。我们的研究结果凸显了在更好地了解疼痛治疗的决定因素时,考虑偏远地区而不仅仅是农村地区的重要性。
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审稿时长
13 weeks
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