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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


Peacock, A and Nielsen, S and Bruno, R and Campbell, G and Larance, B and Degenhardt, L, 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) pp. 2003-2016. ISSN 1526-2375 (2016) [Refereed Article]

Copyright Statement

Copyright 2016 American Academy of Pain Medicine

DOI: doi:10.1093/pm/pnw109


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.

Objective: 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.

Item Details

Item Type:Refereed Article
Keywords:health service utilisation, chronic pain, australia, healthcare, treatment, remote, policy, opioids
Research Division:Psychology
Research Group:Other psychology
Research Field:Other psychology not elsewhere classified
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Public health (excl. specific population health) not elsewhere classified
UTAS Author:Peacock, A (Miss Amy Peacock)
UTAS Author:Bruno, R (Associate Professor Raimondo Bruno)
ID Code:112896
Year Published:2016
Funding Support:National Health and Medical Research Council (110022)
Web of Science® Times Cited:7
Deposited By:Psychology
Deposited On:2016-12-02
Last Modified:2018-03-23

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