Journal of Pain Research (Jul 2019)
Factors associated with waiting times for persons with rheumatic conditions in multidisciplinary pain treatment facilities
Abstract
Simon Deslauriers,1,2 Jean-Sébastien Roy,1,2 Sasha Bernatsky,3–5 Debbie E Feldman,6–8 Anne Marie Pinard,1,2,9 François Desmeules,6,10 Mary-Ann Fitzcharles,3,4 Kadija Perreault1,21Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec, QC, Canada; 2Faculty of Medicine, Université Laval, Québec, QC, Canada; 3McGill University Health Centre (MUHC), Montréal, QC, Canada; 4Faculty of Medicine, McGill University, Montréal, QC, Canada; 5Research Institute of the McGill University Health Centre (RI-MUHC), Montréal, QC, Canada; 6Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; 7Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC, Canada; 8Public Health Research Institute of Université de Montréal, Montréal, QC, Canada; 9Centre Hospitalier Universitaire (CHU) de Québec, Québec, QC, Canada; 10Maisonneuve-Rosemont Hospital (CRHMR) Research Center, Montréal, QC, CanadaObjectives: Access to multidisciplinary pain treatment facilities (MPTF) in Canada is limited by long waiting lists. However, little is known about the factors associated with access to MPTF specifically for persons with rheumatic conditions. This study aimed to 1) determine the waiting time for services in publicly funded MPTF for persons with rheumatic conditions in the province of Quebec, Canada, as well as 2) identify the factors associated with waiting time.Methods: This study was conducted using the Quebec Pain Registry, a large database of patients who received pain management services in MPTF. Sociodemographic and clinical variables were assessed for potential associations with waiting time. Descriptive, bivariate analyses and multiple linear regression analyses were conducted.Results: A total of 3,665 patients with rheumatic conditions were identified within the registry. Patients had a mean age of 55±14 years and the majority were women (65.7%). The average waiting time was 241.2±308.9 days (median=126), with 34.2% of the patients waiting longer than 6 months before having a first appointment. Results indicate that longer pain duration, lower household income, pain onset following a motor vehicle accident, having fibromyalgia, being on permanent disability or unemployed and being referred by a family physician (versus specialist) were significantly associated with longer waiting times.Conclusions: Many patients with rheumatic conditions (especially fibromyalgia) face long delays before receiving services in Quebec’s MPTF. This study identified several factors associated with waiting time and emphasizes the need to improve access to pain management services.Keywords: access, waiting time, rheumatic conditions, chronic pain, multidisciplinary pain treatment facilities