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Care Seeking Practices for Chronic Pain and its correlates among Adults: an experience from a Rural Block of West Bengal

Background: Chronic pain, though a most common cause of disability worldwide, is one of the most underestimated health problems throughout the world. With the ageing population and its increasing prevalence, understanding related care seeking practices is key to plan effective interventions. Objectives: To find out the characteristics of chronic pain and to study related and care-seeking practices and the influence of socio-demographic factors among adult chronic pain sufferers in a rural setting. Methods: Data were collected from 697 adults (>18 years) chronic pain (>12 weeks duration) sufferers chosen randomly from all 81 villages of Amdanga block, West Bengal, through a household-based survey in a cross-sectional design. A pre-designed, pre-tested structured questionnaire containing socio-demographic information, Brief Pain Inventory (BPI) and Patient Health Questionnaire-9 (PHQ-9) was used. During analysis, dimension reduction by Principal Component Analysis was done to derive pain intensity and interference scores. Results: Low back pain and knee pain were first and second most frequent. Major Depressive Syndrome (MDS) was found in 9.04 % [95% CI: 7.95% - 10.13%]. The severity of pain increased with age and decreased with advancing level of education & income. Care-seeking was significantly predicted by MDS (AOR= 0.185), pain intensity (AOR=1.06) & interference (AOR=1.06).Conclusion: Patients tend to seek care more at an advanced severity and more from a private facility. About 1 in 10 persons with chronic pain was seen to suffer from major depression, with which, persons were seen about five times less likely to seek care.