Geographic variation in health service use and perceived access barriers for Australian adults with chronic non-cancer pain receiving opioid therapy

Amy Peacock, Suzanne Nielsen, Raimondo Bruno, Gabrielle Campbell, Briony Larance, Louisa Degenhardt

Research output: Contribution to journalArticleResearchpeer-review

6 Citations (Scopus)

Abstract

Objective. Rates of chronic non-cancer pain are increasing worldwide, with concerns regarding poorer access to specialist treatment services in remote areas. The current study comprised the first in-depth examination of use and barriers to access of health services in Australia according to remoteness. Methods. A cohort of Australian adults prescribed pharmaceutical opioids for chronic non-cancer pain (n51,235) were interviewed between August 2012 and April 2014, and grouped into ‘major city’ (49%), ‘inner regional’ (37%), and ‘outer regional/remote’ (14%) according to the Australian Standard Geographical Classification based on postcode. Multinomial logistic regression analyses were conducted to determine geographical differences in socio-demographic and clinical characteristics, health service use, and perceived barriers to health service access. Results. The ‘inner regional group’ and ‘outer regional/ remote group’ were more likely to be male (relative risk ratio (RRR)51.38,95%CI 1.08–1.77 and RRR51.60, 95%CI 1.14–2.24) and have no private health insurance (RRR51.53, 95%CI 1.19–1.97 and RRR51.65, 95%CI 1.16–2.37) than the ‘major city group’ (49%). However, the ‘inner regional group’ reported lower pain severity and better mental health relative to the ‘major city group’5 0.92, 95%CI 0.86–0.98 and RRR51.02, 95%CI 1.01– 1.03, respectively). Although rates of health service access were generally similar, the ‘outer regional/remote group’ were more likely to report client-practitioner communication problems (RRR51.57, 95%CI 1.03–2.37), difficulties accessing specialists (RRR51.56, 95%CI 1.01–2.39), and perception of practitioner lack of confidence in prescribing pain medication (RRR51.73, 1.14–2.62), relative to both groups. Conclusion. Perceived communication, access, and financial barriers to healthcare indicate the need for increased efforts to address geographic inequality in pain treatment.

Original languageEnglish
Pages (from-to)2003-2016
Number of pages14
JournalPain Medicine
Volume17
Issue number11
DOIs
Publication statusPublished - 1 Nov 2016
Externally publishedYes

Keywords

  • Chronic pain
  • Healthcare
  • Opioids
  • Policy
  • Remote
  • Treatment

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