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

Tyrone F. Borders, Ke Tom Xu, James Heavner, Gina Kruse

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations


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.

Original languageEnglish
Article number4
JournalBMC Health Services Research
StatePublished - Jan 14 2005

ASJC Scopus subject areas

  • Health Policy


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