Predictors of pain severity among community-dwelling older adults with pain in the United States: Findings from a cross-sectional, retrospective study using 2017 Medical Expenditure Panel Survey

The purpose of this study was to determine predictors of pain severity among older United States (US) adults with pain.This cross-sectional, retrospective study utilized 2017 Medical Expenditure Panel Survey data. Eligible participants were alive for the calendar year, aged ≥50 years, and reported pain in the past 4weeks. Hierarchical logistic regression models, adjusting for the survey design, were used to identify significant predictors of pain severity (i.e., extreme/quite a bit or moderate/little pain).An estimated 14,250,534 adults aged ≥50 with pain reported extreme/quite a bit of pain. Many variables were associated with extreme/quite a bit of pain, including: age 50 to 64 vs ≥65years (adjusted odds ratio [AOR]=1.49, 95% confidence interval [95% CI]=1.22-1.82); males vs females (AOR=0.80, 95% CI=0.67-0.95); white race vs others (AOR=0.75, 95% CI=0.61-0.92); married vs other marital status (AOR=1.31, 95% CI=1.08-1.57); income <200% vs ≥200% federal poverty level (AOR=1.30, 95% CI=1.06-1.60); employed vs unemployed (AOR=0.47, 95% CI=0.37-0.60); limitation vs no limitation (AOR=2.64, 95% CI=2.09-3.33); 0, 1, 3, or 4 vs ≥5 chronic conditions (AOR ranged from 0.39 for 0 conditions to 0.77 for 4 conditions); excellent/very good or good vs fair/poor perceived physical health status (AOR ranged from 0.28 for excellent/very good to 0.40 for good); smokers vs non-smokers (AOR=1.56, 95% CI=1.27-1.93); exercise versus no exercise (AOR=0.74, 95% CI=0.62-0.88); and South vs West census region (AOR=1.34, 95% CI=1.04-1.74).This study found several characteristics could predict pain severity among older US adults who reported extreme/quite a bit of pain. These characteristics may guide specific areas of focus to improve patients' pain management.