Salient concerns in using analgesia for cancer pain among outpatients: A cluster analysis study

Table 1 Baseline sociodemographic variables (n = 207)

Variable	Range	n (%)1	Mean (SD)
Age	23-75		53.8 (11.1)
Education	Elementary	3 (1.5)
	High school	70 (33.8)
	College/Trade school	101 (48.8)
	More than college	33 (15.9)
Employment status	Employed outside home (full-time)	43 (20.8)
	Employed outside home (part-time)	12 (5.8)
	Employed at home (full-time)	4 (1.9)
	Employed at home (part-time)	4 (1.8)
	Retired	44 (21.3)
	Unemployed	25 (12.1)
	Other	75 (36.2)
Health literacy	3-15		13.1 (2.6)
Income	< $10000	28 (13.5)
	$10000-$20000	26 (12.6)
	$20000-$30000	19 (9.2)
	$30000-$50000	36 (17.4)
	$50000-$70000	37 (17.9)
	$70000-$90000	24 (11.6)
	> $90000	37 (17.9)
Primary insurance (1 missing)	Private	107 (51.9)
	Medicare	41 (19.9)
	Medicaid	27 (13.1)
	Multiple	25 (12.1)
	VA/other	6 (2.9)
Marital status	Married	110 (53.1)
	Separated/Divorced	48 (23.2)
	Widowed	8 (3.9)
	Never married	41 (19.8)
Race	Black/African American	86 (41.5)
	White/Caucasian	121 (58.5)
Social support	0.17-9.00		3.7 (2.1)

¹No missing values unless otherwise indicated. SD: Standard deviation; VA: Veterans Administration.

Table 2 Baseline illness and pain variables (n = 207)

Variable	Range	n (%)1	Mean (SD)
Cancer stage	I	20 (9.7)
	II	33 (15.9)
	III	37 (17.9)
	IV	64 (30.9)
	Unknown or unsure	53 (25.6)
Time since cancer diagnosis	1-120 mo		36.7 (35.5)
Charlson comorbidity index	0-13		4.3 (2.6)
General health	Excellent	9 (4.3)
	Very good	23 (11.1)
	Good	63 (30.4)
	Fair	77 (37.2)
	Poor	35 (16.9)
Physical health not good (number of days within last 30 d)	0-30		14.7 (10.7)
Mental health not good (number of days within last 30 d)	0-30		9.5 (10.7)
Past history of substance abuse	No	172 (83.1)
	Yes	35 (16.9)
Presence of depression	No	120 (58.0)
	Yes	87 (42.0)
Worst pain (last week)	0-10 (no pain - pain as bad as you can imagine)		6.9 (2.4)
Average pain (last week)	0-10 (no pain - pain as bad as you can imagine)		4.9 (2.1)
Least pain (last week)	0-10 (no pain - pain as bad as you can imagine)		3.4 (2.0)
Pain-related functional interference score	7-70 (does not interfere-completely interferes)		35.2 (15.9)
Pain relief with medications (last week)	1-10 (10%-100%)		7.2 (2.1)
Pain management index	-2	5 (2.4)
	-1	13 (6.3)
	0	92 (44.4)
	1	63 (30.4)
	2	31 (15.0)
	3	3 (1.4)
Number of analgesic side effects (MSEC)	0-8		3.8 (2.4)
Severity of analgesic side effects (MSEC)	8-80 (not severe-extremely severe)		25.2 (15.0)
BQ-II analgesic barriers (total)	0-96		39.8 (20.1)
No. of complementary alternative modalities used	0-8		2.1 (1.7)

¹No missing values unless otherwise indicated. BQ-II: Barriers questionnaire; MSEC: Medication Side-effects Checklist; SD: Standard deviation.

Table 3 Description of analgesic preference clusters (n = 207)

Cluster	n (%)	Salient concern(s)
1	84 (40.6)	Pain relief
2	23 (11.1)	Type of analgesic
3	57 (27.5)	Pain relief, type of side-effects and severity of side-effects
4	43 (20.8)	Type of side-effects

Table 4 Multiple binary characteristics model for cluster 1 (pain relief)

Variable domain	Variable	Characteristic	n (% out of 207)	P value	OR	95%CI
Sociodemographic	Education	College/trade school or more than college vs Elementary or High school	134 (64.7)	0.001	3.88	1.75-8.59
Illness	Physical health not good (number of days within last 30 d)	≥ 22 vs < 22	59 (28.5)	0.002	2.81	1.47-5.38
Pain, function and pain treatment	NS
Analgesic attitudes and barriers	BQ-II item - pain medicine can mask changes in your health	≤ 3 vs > 3	158 (76.3)	0.016	2.26	1.17-4.36

BQ-II: Barriers questionnaire II; CI: Confidence interval; OR: Odds ratio; NS: None significant.

Table 5 Multiple binary characteristics model for cluster 2 (type of analgesic)

Variable domain	Variable	Characteristic	n (% out of 207)	P value	OR	95%CI
Sociodemographic	Health literacy	= 15 vs < 15	93 (44.9)	0.006	3.86	1.46-10.2
	Income	≤ $50000 vs < $50000	109 (52.7)	0.017	3.64	1.26-10.5
	Social support	≤ 4.17 vs > 4.17	137 (66.2)	0.027	4.25	1.18-15.4
Illness	NS
Pain, function and pain treatment	NS
Analgesic attitudes and barriers	NS

CI: Confidence interval; OR: Odds ratio; NS: None significant.

Table 6 Multiple binary characteristics model for cluster 3 (pain relief, type of side-effects and severity of side-effects)

Variable domain	Variable	Characteristic	n (% out of 207)	P value	OR	95%CI
Sociodemographic	Marital status	Married vs Separated, Divorced, Widowed or Never married	110 (53.1)	0.023	2.26	1.12-4.56
	Social support	≥ 1.83 vs < 1.83	177 (85.5)	0.022	4.55	1.24-16.7
Illness	Mental health not good (number of days within last 30 d)	≥ 2 vs < 2	140 (67.6)	0.002	3.46	1.55-772
Pain, function and pain treatment	Average pain (last week)	≤ 6 vs > 6	163 (78.7)	0.01	4.41	1.42-6.86
	Severity of analgesic side effects (MSEC)	≤ 28 vs > 28	133 (64.3)	0.005	3.11	1.41-6.86
Analgesic attitudes and barriers	NS

CI: Confidence interval; OR: Odds ratio; MSEC: Medication Side-effects Checklist; NS: None significant.

Table 7 Multiple binary characteristics model for cluster 4 (type of side-effects)

Variable domain	Variable	Characteristic	n (% out of 207)	P value	OR	95%CI
Sociodemographic	Health literacy	≤ 13 vs > 13	84 (40.6)	0.004	3.11	1.43-6.76
Illness	Mental health not good (number of days within last 30 d)	≤ 12 vs > 12	144 (69.6)	0.001	6.18	2.06-18.5
Pain, function and pain treatment	Severity of analgesic side effects (MSEC)	≥ 40 vs < 40	37 (17.9)	0.002	4.19	1.68-10.5
Analgesic attitudes and barriers	BQ-II item - pain medicine can keep you from knowing what’s going on in your body	≥ 4 vs < 4	42 (20.3)	< 0.001	5.25	2.32-11.9

BQ-II: Barriers questionnaire; MSEC: Medication Side-effects Checklist; CI: Confidence interval; OR: Odds ratio.