Pain among Veterans of Operations Enduring Freedom and Iraqi Freedom: Do Women and Men Differ?

Authors

  • Sally G. Haskell MD,

    1. VA Connecticut Healthcare System, West Haven, Connecticut;
    2. Departments of Psychiatry, Neurology and Psychology, Yale University School of Medicine, New Haven, Connecticut;
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  • Cynthia A. Brandt MD, MPH,

    1. VA Connecticut Healthcare System, West Haven, Connecticut;
    2. Departments of Psychiatry, Neurology and Psychology, Yale University School of Medicine, New Haven, Connecticut;
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  • Erin E. Krebs MD, MPH,

    1. Roudebush VA Center on Implementing Evidence-Based Practice, Indianapolis, Indiana;
    2. Indiana University School of Medicine, Indianapolis, Indiana;
    3. Regenstrief Institute, Inc., Indianapolis, Indiana;
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  • Melissa Skanderson MSW,

    1. VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
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  • Robert D. Kerns PhD,

    1. VA Connecticut Healthcare System, West Haven, Connecticut;
    2. Departments of Psychiatry, Neurology and Psychology, Yale University School of Medicine, New Haven, Connecticut;
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  • Joseph L. Goulet PhD, MS

    Corresponding author
    1. VA Connecticut Healthcare System, West Haven, Connecticut;
    2. Departments of Psychiatry, Neurology and Psychology, Yale University School of Medicine, New Haven, Connecticut;
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  • Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

Joseph L. Goulet, PhD, MS, VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT 06516, USA. Tel: 203-932-5711 ext. 5325; Fax: 203-937-4926; E-mail: Joseph.Goulet@VA.gov.

ABSTRACT

Objective.  To evaluate sex differences in the prevalence of overall pain, moderate-severe pain, and persistent pain among Veterans of Operations Enduring Freedom and Iraqi Freedom seen at VA outpatient clinics, and to evaluate sex differences in pain assessment.

Design.  The observational cohort consisted of Veterans discharged from the U.S. military from October 1, 2001 to November 30, 2007 that enrolled for Veterans Administration (VA) services or received VA care before January 1, 2008. We limited the sample to the 153,212 Veterans (18,481 female, 134,731 male) who had 1 year of observation after their last deployment.

Results.  Pain was assessed in 59.7% (n = 91,414) of Veterans in this sample. Among those assessed, 43.3% (n = 39,591) reported any pain, 63.2% (n = 25,028) of whom reported moderate-severe pain. Over 20% (n = 3,427) of Veterans with repeated pain measures reported persistent pain. We found no significant difference in the probability of pain assessment by sex (RR = 0.98, 95% CI 0.96, 1.00). Female Veterans were less likely to report any pain (RR 0.89, 95% CI 0.86, 0.92). Among those with any pain, female Veterans were more likely to report moderate–severe pain (RR 1.05, 95% CI 1.01, 1.09) and less likely to report persistent pain (RR 0.90, 95% CI 0.81, 0.99).

Conclusions.  As the VA plans care for the increasing numbers of female Veterans returning from Iraq and Afghanistan, a better understanding of the prevalence of pain, as well as sex-specific variations in the experience and treatment of pain, is important for policy makers and providers who seek to improve identification and management of diverse pain disorders.

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