Mental Health and Clinical Neurosciences Division, Portland VA Medical Center, Portland, Oregon Department of Psychiatry, Oregon Health & Scien Pain Med. 2012 Sep 7. doi: 10.1111/j.1526-4637.2012.01476.x. [Epub ahead of print]
ce University, Portland, Oregon Portland Center for the Study of Chronic, Comorbid Mental and Physical Disorders, Portland VA Medical Center, Portland, Oregon School of Professional Psychology, Pacific University, Hillsboro, Oregon Portland VA Research Foundation, Portland, Oregon Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA.
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.