Pain severity, interference, and prescription analgesic use among depressed, low-income homebound older adults.
Disabled, homebound individuals tend to suffer both chronic pain and depression; however, low-income, homebound older adults have been underexposed in pain and depression research. We examined the extent of pain frequency, intensity, and interference; the relationship between pain and depressive symptoms; and prescription analgesic use and its association with use of antidepressant and anxiolytic medications among these older adults.



The data came from the baseline assessment of 215 homebound individuals aged 50+ who were referred to a clinical trial of depression treatment. Bivariate and multivariate analyses were used to examine the research questions.



Almost 87% (n = 186) of the participants reported having had chronic pain in the preceding three months. Of the pain reporters, the mean frequency, intensity, and interference of pain were 8.65 ± 2.05, 7.71 ± 2.10, and 7.80 ± 2.82, respectively, on a 1-10 scale, and 61% were taking a prescription analgesic. Analgesic users and nonusers did not differ in depressive symptoms and in pain frequency and intensity, but analgesic users reported higher pain interference than nonusers (8.22 ± 2.46 vs. 7.14 ± 3.22; t = 2.44, df = 184, p = .016). Pain frequency and interference were significantly associated with depressive symptoms, and pain interference was significantly associated with analgesic use in multivariate analysis. Anxiolytic medication use was also correlated with analgesic use.



The findings underscore the significant pain-related problems in these vulnerable individuals and the need for recognizing and treating both pain and depression more effectively using both pharmacologic and nonpharmacologic interventions.
a The University of Texas at Austin School of Social Work , Austin , TX , USA.
Namkee G
NG
Choi
b Department of Psychology , University of Alabama Center for Mental Health and Aging , Tuscaloosa , AL , USA.
A Lynn
AL
Snow
c The Center for Innovations in Quality, Effectiveness and Safety (#CIN 13-413) , Michael E. DeBakey VA Medical Center , Houston , TX , USA.|d Houston VA Health Services Research and Development Center of Excellence , Houston , TX , USA.|e Department of Psychiatry , Baylor College of Medicine , Houston , TX , USA.
Mark E
ME
Kunik
D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy* / Q000503:physiopathology*; D003863:Depression; D005260:Female; D018577:Homebound Persons; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011203:Poverty; D036301:Qualitative Research; D012720:Severity of Illness Index
D000700:Analgesics
depression; homebound older adults; pain; prescription pain medication