TY - JOUR
T1 - A longitudinal linear model of patient characteristics to predict failure to attend an inner-city chronic pain clinic
AU - Shaparin, Naum
AU - White, Robert
AU - Andreae, Michael
AU - Hall, Charles
AU - Kaufman, Andrew
N1 - Funding Information:
R.W. is supported by grants UL1TR000086, TL1RR000087, and KL2TR000088. C.H. is supported by CDC grants 1U01-OH10412-01 (Project Primary Investigator), 1U01OH010411-01 , 1U01OH010513-01 , NIH grants P01 AG03949 , R01 AG034119 , 2R01AG022092-06A1 , 1UL1TR001073-01 , and 5P30-CA013330-40 , along with CDC contracts 200-2011-39378 and 200-2011-39489. A.K. and N.S. report no grant support. N.S. serves on the Speaker's Bureau for Cadence Pharmaceutical and Salix Pharmaceuticals. A.K. serves on the Speaker's Bureau for Perdue Pharma, Insys Pharmaceuticals, and Jazz Pharmaceuticals. C.H.'s wife received a $300 fee for record review from Services for the Underserved, New York, NY. R.W. and M.A. report no conflicts of interest.
PY - 2014/7
Y1 - 2014/7
N2 - Patients often fail to attend appointments in chronic pain clinics for unknown reasons. We hypothesized that certain patient characteristics predict failure to attend scheduled appointments, pointing to systematic barriers to accessing chronic pain services for certain underserved populations. We collected retrospective data from a longitudinal observational cohort of patients at an academic pain clinic in Newark, New Jersey. To examine the effect of demographic factors on appointment status, we fit a marginal logistic regression using generalized estimating equations with exchangeable correlation. A total of 1,394 patients with 3,488 total encounters between January 1, 2006, and December 31, 2009, were included. Spanish spoken as a primary language (alternatively Hispanic or other race) and living between 5 and 10 miles from the clinic were associated with reduced odds of arriving for an appointment; making an appointment for a particular complaint such as cancer pain or back pain, an interventional pain procedure scheduled in connection with the appointment, unemployed status, and continuity of care (as measured by office visit number) were associated with increased odds of arriving. Spanish spoken as a primary language and distance to the pain clinic predicted failure to attend a scheduled appointment in our cohort. If these constitute systematic barriers to access, they may be amenable to targeted interventions. Perspective We identified certain patient characteristics, specifically Spanish spoken as a primary language and geographic distance from the clinic, that predict failure to attend an inner-city chronic pain clinic. These identified barriers to accessing chronic pain services may be modifiable by simple cost-effective interventions.
AB - Patients often fail to attend appointments in chronic pain clinics for unknown reasons. We hypothesized that certain patient characteristics predict failure to attend scheduled appointments, pointing to systematic barriers to accessing chronic pain services for certain underserved populations. We collected retrospective data from a longitudinal observational cohort of patients at an academic pain clinic in Newark, New Jersey. To examine the effect of demographic factors on appointment status, we fit a marginal logistic regression using generalized estimating equations with exchangeable correlation. A total of 1,394 patients with 3,488 total encounters between January 1, 2006, and December 31, 2009, were included. Spanish spoken as a primary language (alternatively Hispanic or other race) and living between 5 and 10 miles from the clinic were associated with reduced odds of arriving for an appointment; making an appointment for a particular complaint such as cancer pain or back pain, an interventional pain procedure scheduled in connection with the appointment, unemployed status, and continuity of care (as measured by office visit number) were associated with increased odds of arriving. Spanish spoken as a primary language and distance to the pain clinic predicted failure to attend a scheduled appointment in our cohort. If these constitute systematic barriers to access, they may be amenable to targeted interventions. Perspective We identified certain patient characteristics, specifically Spanish spoken as a primary language and geographic distance from the clinic, that predict failure to attend an inner-city chronic pain clinic. These identified barriers to accessing chronic pain services may be modifiable by simple cost-effective interventions.
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U2 - 10.1016/j.jpain.2014.03.004
DO - 10.1016/j.jpain.2014.03.004
M3 - Article
C2 - 24747766
AN - SCOPUS:84903612931
SN - 1526-5900
VL - 15
SP - 704
EP - 711
JO - Journal of Pain
JF - Journal of Pain
IS - 7
ER -