TY - JOUR
T1 - Correlates of Health Care Seeking Activities in Patients with Urological Chronic Pelvic Pain Syndromes
T2 - Findings from the MAPP Cohort
AU - MAPP Research Network
AU - Clemens, J. Quentin
AU - Stephens-Shields, Alisa
AU - Naliboff, Bruce D.
AU - Lai, H. Henry
AU - Rodriguez, Larissa
AU - Krieger, John N.
AU - Williams, David A.
AU - Kusek, John W.
AU - Landis, J. Richard
N1 - Funding Information:
Supported by United States National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases Grants U01 DK082315, U01 DK82316, U01 DK82325, U01 DK82333, U01 DK82342, U01 DK82344, U01 DK82345 and U01 DK82370.
Publisher Copyright:
© 2018 American Urological Association Education and Research, Inc.
PY - 2018/7
Y1 - 2018/7
N2 - Purpose: We examined health care seeking activities during a 12-month period in a cohort of men and women with urological chronic pelvic pain syndromes. Materials and Methods: A total of 191 men and 233 women with urological chronic pelvic pain syndrome were followed with biweekly, Internet based questionnaires about symptoms and health care seeking activities, including 1) health care provider contacts, 2) office visits, 3) emergency room/urgent care visits, 4) medication changes and 5) medical procedures. Multivariable modeling was used to determine the association of demographic and clinical variables with health care seeking. Super users were defined as individuals who reported health care seeking activity at least 11 times during the 23 biweekly assessments. Results: Health care seeking activities included a mean of 2.4 office contacts, 2.5 office visits, 1.9 medication changes, 0.9 medical procedures and 0.3 emergency room/urgent care visits. A total of 31 health care seeking super users accounted for 26% of health care seeking activities. Worse baseline pain severity and female gender were associated with a higher rate of all health care seeking activities except emergency room/urgent care visits. A nonurological chronic pain condition was associated with more provider contacts, office visits and medical procedures. Greater baseline depression symptoms were associated with more provider contacts, office visits and medication changes. Other examined variables, including patient age, symptom duration, catastrophizing, anxiety, urinary symptom severity and symptom variability, had a minimal association with health care seeking. Conclusions: Health care seeking activities were strongly influenced by the severity of pain in patients with urological chronic pelvic pain syndromes but not by urinary symptom severity. Women and patients with nonurological overlapping pain conditions were more likely to be seen and treated for symptoms.
AB - Purpose: We examined health care seeking activities during a 12-month period in a cohort of men and women with urological chronic pelvic pain syndromes. Materials and Methods: A total of 191 men and 233 women with urological chronic pelvic pain syndrome were followed with biweekly, Internet based questionnaires about symptoms and health care seeking activities, including 1) health care provider contacts, 2) office visits, 3) emergency room/urgent care visits, 4) medication changes and 5) medical procedures. Multivariable modeling was used to determine the association of demographic and clinical variables with health care seeking. Super users were defined as individuals who reported health care seeking activity at least 11 times during the 23 biweekly assessments. Results: Health care seeking activities included a mean of 2.4 office contacts, 2.5 office visits, 1.9 medication changes, 0.9 medical procedures and 0.3 emergency room/urgent care visits. A total of 31 health care seeking super users accounted for 26% of health care seeking activities. Worse baseline pain severity and female gender were associated with a higher rate of all health care seeking activities except emergency room/urgent care visits. A nonurological chronic pain condition was associated with more provider contacts, office visits and medical procedures. Greater baseline depression symptoms were associated with more provider contacts, office visits and medication changes. Other examined variables, including patient age, symptom duration, catastrophizing, anxiety, urinary symptom severity and symptom variability, had a minimal association with health care seeking. Conclusions: Health care seeking activities were strongly influenced by the severity of pain in patients with urological chronic pelvic pain syndromes but not by urinary symptom severity. Women and patients with nonurological overlapping pain conditions were more likely to be seen and treated for symptoms.
KW - cystitis
KW - interstitial
KW - patient acceptance of health care
KW - pelvic pain
KW - prostate
KW - urinary bladder
UR - http://www.scopus.com/inward/record.url?scp=85047182381&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2017.12.055
DO - 10.1016/j.juro.2017.12.055
M3 - Article
C2 - 29307682
AN - SCOPUS:85047182381
SN - 0022-5347
VL - 200
SP - 136
EP - 140
JO - Journal of Urology
JF - Journal of Urology
IS - 1
ER -