Chronic Pain and Social Pain: Loneliness, Healthcare Utilization, and Associated Characteristics in a Cross-Section of Patients Receiving Opioids for Chronic Pain

Abstract

Introduction: Loneliness is detrimental to several domains of health and quality of life, and is sometimes linked to higher healthcare utilization (HCU). Individuals prescribed opioids for chronic pain experience loneliness more frequently than the general population. Patients with chronic pain utilize more health services than the general population. Discovering characteristics associated with loneliness in this patient population could help prioritize the delivery of appropriate interventions and reduce unnecessary healthcare utilization.Methods: This is an analysis of cross-sectional survey data collected as part of the screening process for a clinical trial testing a social navigation intervention. The population was patients being prescribed long-term opioids for chronic pain. Characteristics associated with loneliness were identified via Ꭓ2 tests and logistic regression. Associations between loneliness and number of primary care visits, emergency room visits, and behavioral healthcare visits were measured using negative binomial regression. Regression models were adjusted for predictors of health service use selected from the Andersen Model of Health Service Utilization. Results: The sample size was n=278. Characteristics associated with loneliness were social isolation( OR=1.33, 95%CI=1.18-1.51), pain severity, (OR=1.04, 95% CI=1.01-1.07), and living alone (OR=1.21, 95% CI=1.06-1.39). Being aged 65+ was associated with lower odds of loneliness (OR=0.768, 95% CI=0.650-0.908). Loneliness was not associated with increased primary care or ER visits. Loneliness appeared to have a moderate association with increased behavioral health visits (IRR=1.99, p=0.030), but this result was not significant under a Benjamini-Hochberg correction. Conclusion: Given the prevalence of loneliness and chronic pain, there is a need for more research. Future researchers should consider revisiting this topic using longitudinal study designs with larger sample sizes.