Chronic Pain Treatment and Health Service Utilization of Veterans with Hepatitis C Virus Infection

Authors

  • Travis I. Lovejoy PhD, MPH,

    Corresponding author
    1. Mental Health and Clinical Neurosciences Division, Portland VA Medical Center, Portland, Oregon
      Travis I. Lovejoy, PhD, MPH, Portland VA Medical Center, P3MHDC, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239, USA. Tel: 503-220-8262 x58272; Fax: 503-402-2830; E-mail: travis.lovejoy@va.gov.
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  • Steven K. Dobscha MD,

    1. Mental Health and Clinical Neurosciences Division, Portland VA Medical Center, Portland, Oregon
    2. Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
    3. Portland Center for the Study of Chronic, Comorbid Mental and Physical Disorders, Portland VA Medical Center, Portland, Oregon
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  • Renee Cavanagh BA,

    1. School of Professional Psychology, Pacific University, Hillsboro, Oregon
    2. Portland VA Research Foundation, Portland, Oregon
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  • Dennis C. Turk PhD,

    1. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA
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  • Benjamin J. Morasco PhD

    1. Mental Health and Clinical Neurosciences Division, Portland VA Medical Center, Portland, Oregon
    2. Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
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  • Conflict of interest and acknowledgment of support: No author reports having any financial or other potential conflict of interest with this study. This study was supported in part by award K23DA023467 from the United States National Institute on Drug Abuse to Dr. Morasco.

Travis I. Lovejoy, PhD, MPH, Portland VA Medical Center, P3MHDC, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239, USA. Tel: 503-220-8262 x58272; Fax: 503-402-2830; E-mail: travis.lovejoy@va.gov.

Abstract

Objectives.  Hepatitis C virus (HCV) infection is estimated to affect 2% of the general U.S. population and chronic pain is a common comorbidity among persons with HCV. The primary purpose of this study was to compare health service utilization of U.S. military veterans with HCV with and without the presence of comorbid chronic pain.

Design.  Cross-sectional study with retrospective review of patient medical records.

Patients.  One hundred seventy-one U.S. military veterans with confirmed HCV, recruited through a single U.S. Veterans Administration hospital.

Outcome Measures.  Medical service utilization data from the past 5 years were extracted from participants' electronic medical records.

Results.  Sixty-four percent of veterans with HCV (N = 110) had chronic pain. Veterans with HCV and chronic pain utilized more health services including total inpatient stays (odds ratio [OR] = 2.58 [1.46, 4.56]) and days hospitalized for psychiatric services (OR = 5.50 [3.37, 8.99]), compared to participants with HCV and no chronic pain, after statistically adjusting for demographic, psychiatric, substance use, medical comorbidity, and disability covariates. In addition, those with HCV and chronic pain had more total outpatient visits with primary care providers (OR = 1.73 [1.15, 2.59]), physical therapists (OR = 9.57 [4.79, 19.11]), and occupational therapists (OR = 2.72 [1.00, 7.48]).

Conclusions.  Patients with HCV and chronic pain utilize medical services to a greater extent than patients with HCV but no chronic pain. Future studies that examine the efficacy of both pharmacological and nonpharmacological pain treatment for patients with comorbid HCV and chronic pain appear warranted.

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