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Open AccessResearch article

Patient involvement in medical decision-making and pain among elders: physician or patient-driven?

Tyrone F Borders1 email, Ke Tom Xu2 email, James Heavner3 email and Gina Kruse4 email

1Department of Health Management and Policy, University of North Texas School of Public Health, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA

2Division of Health Services Research, Texas Tech University School of Medicine, Lubbock, Texas, USA

3Department of Anesthesiology, Texas Tech University School of Medicine, Lubbock, Texas, USA

4Baylor Medical School, Houston, Texas, USA

author email corresponding author email

BMC Health Services Research 2005, 5:4doi:10.1186/1472-6963-5-4

Published: 14 January 2005

Abstract

Background

Pain is highly prevalent among older adults, but little is known about how patient involvement in medical decision-making may play a role in limiting its occurrence or severity. The purpose of this study was to evaluate whether physician-driven and patient-driven participation in decision-making were associated with the odds of frequent and severe pain.

Methods

A cross-sectional population-based survey of 3,135 persons age 65 and older was conducted in the 108-county region comprising West Texas. The survey included self-reports of frequent pain and, among those with frequent pain, the severity of pain.

Results

Findings from multivariate logistic regression analyses showed that higher patient-driven participation in decision-making was associated with lower odds (OR, 0.82; 95% CI, 0.75–0.89) of frequent pain, but was not significantly associated with severe pain. Physician-driven participation was not significantly associated with frequent or severe pain.

Conclusions

The findings suggest that patients may need to initiate involvement in medical decision-making to reduce their chances of experiencing frequent pain. Changes to other modifiable health care characteristics, including access to a personal doctor and health insurance coverage, may be more conducive to limiting the risk of severe pain.


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