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Social Support and Pain Outcomes after Trauma Exposure among Older Adults: A Multicenter Longitudinal Study

Richmond, Natalie L. BA*; Meyer, Michelle L. PhD, MPH; Hollowell, Allison G. BS*; Isenberg, Erin E. BSPH*; Domeier, Robert M. MD; Swor, Robert A. DO§; Hendry, Phyllis L. MD; Peak, David A. MD; Rathlev, Niels K. MD#; Jones, Jeffrey S. MD**; Lee, David C. MD††; Jones, Christopher W. MD‡‡; Platts-Mills, Timothy F. MD, MSc§§

doi: 10.1097/AJP.0000000000000545
Original Article: PDF Only

Objectives: Certain forms of social support have been shown to improve pain coping behaviors and pain outcomes in older adults with chronic pain, but little is known about the effect of social support on pain outcomes in older adults following trauma exposure.

Methods: We analyzed data from a prospective longitudinal study of adults aged 65 years and older presenting to an emergency department (ED) after a motor vehicle collision (MVC) to characterize the relationship between perceived social support and MVC-related pain after trauma overall and by subgroups based on gender, depressive symptoms, and marital status.

Results: In our sample (N=176), patients with low perceived social support had higher pain severity 6 weeks after MVC than patients with high perceived social support after adjustment for age, gender, race, and education (4.2 vs. 3.2, P=0.04). The protective effect of social support on pain severity at 6 weeks was more pronounced in men and in married individuals. Patients with low social support were less likely to receive an opioid prescription in the ED (15% vs. 32%, P=0.03), but there was no difference in opioid use at 6 weeks (22% vs. 20%, P=0.75).

Discussion: Among older adults experiencing trauma, low perceived social support was associated with higher levels of pain at 6 weeks.

Supplemental Digital Content is available in the text.

*University of North Carolina at Chapel Hill, School of Medicine

University of North Carolina at Chapel Hill, Department of Emergency Medicine

St. Joseph Mercy Health System, Department of Emergency Medicine

§William Beaumont Hospital, Department of Emergency Medicine

University of Florida College of Medicine Jacksonville, Department of Emergency Medicine

Massachusetts General Hospital, Department of Emergency Medicine

#Baystate Medical Center, Department of Emergency Medicine

**Spectrum Health – Butterworth Campus, Department of Emergency Medicine

††North Shore University Hospital, Department of Emergency Medicine

‡‡Cooper University Hospital, Department of Emergency Medicine

§§Department of Emergency Medicine and Department of Anesthesiology, University of North Carolina Chapel Hill

Reprints: Reprints not available from the author.

Funding: This study was supported by Award Number K23AG038548 (Platts-Mills) from the National Institute on Aging. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging.

Role of the Sponsors: None of the sponsors had a role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation, review or approval of the manuscript.

The authors declare no conflict of interest.

Reprints: Timothy F. Platts-Mills, MD, MSc, Department of Emergency Medicine and Department of Anesthesiology, University of North Carolina Chapel Hill, 101 Manning Drive, CB #7010, Chapel Hill, NC 27599-7010 (e-mail: tplattsm@med.unc.edu).

Received March 13, 2017

Accepted August 11, 2017

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