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Geographic Variation in Health Service Use and Perceived Access Barriers for Australian Adults with Chronic Non-Cancer Pain Receiving Opioid Therapy

Journal Article


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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 (n = 1,235) 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)=1.38,95%CI 1.08–1.77 and RRR = 1.60, 95%CI 1.14–2.24) and have no private health insurance (RRR = 1.53, 95%CI 1.19–1.97 and RRR = 1.65, 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’ = 0.92, 95%CI 0.86–0.98 and RRR = 1.02, 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 (RRR = 1.57, 95%CI 1.03–2.37), difficulties accessing specialists (RRR = 1.56, 95%CI 1.01–2.39), and perception of practitioner lack of confidence in prescribing pain medication (RRR = 1.73, 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.

UOW Authors


  •   Peacock, Amy (external author)
  •   Nielsen, Suzanne (external author)
  •   Bruno, Raimondo (external author)
  •   Campbell, Gabrielle (external author)
  •   Larance, Briony
  •   Degenhardt, Louisa (external author)

Publication Date


  • 2016

Citation


  • Peacock, A., Nielsen, S., Bruno, R., Campbell, G., Larance, B. & Degenhardt, L. (2016). Geographic Variation in Health Service Use and Perceived Access Barriers for Australian Adults with Chronic Non-Cancer Pain Receiving Opioid Therapy. Pain Medicine, 17 (11), 2003-2016.

Ro Full-text Url


  • https://ro.uow.edu.au/cgi/viewcontent.cgi?article=5203&context=sspapers

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/4178

Number Of Pages


  • 13

Start Page


  • 2003

End Page


  • 2016

Volume


  • 17

Issue


  • 11

Place Of Publication


  • United States

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 (n = 1,235) 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)=1.38,95%CI 1.08–1.77 and RRR = 1.60, 95%CI 1.14–2.24) and have no private health insurance (RRR = 1.53, 95%CI 1.19–1.97 and RRR = 1.65, 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’ = 0.92, 95%CI 0.86–0.98 and RRR = 1.02, 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 (RRR = 1.57, 95%CI 1.03–2.37), difficulties accessing specialists (RRR = 1.56, 95%CI 1.01–2.39), and perception of practitioner lack of confidence in prescribing pain medication (RRR = 1.73, 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.

UOW Authors


  •   Peacock, Amy (external author)
  •   Nielsen, Suzanne (external author)
  •   Bruno, Raimondo (external author)
  •   Campbell, Gabrielle (external author)
  •   Larance, Briony
  •   Degenhardt, Louisa (external author)

Publication Date


  • 2016

Citation


  • Peacock, A., Nielsen, S., Bruno, R., Campbell, G., Larance, B. & Degenhardt, L. (2016). Geographic Variation in Health Service Use and Perceived Access Barriers for Australian Adults with Chronic Non-Cancer Pain Receiving Opioid Therapy. Pain Medicine, 17 (11), 2003-2016.

Ro Full-text Url


  • https://ro.uow.edu.au/cgi/viewcontent.cgi?article=5203&context=sspapers

Ro Metadata Url


  • http://ro.uow.edu.au/sspapers/4178

Number Of Pages


  • 13

Start Page


  • 2003

End Page


  • 2016

Volume


  • 17

Issue


  • 11

Place Of Publication


  • United States