Browsing by Author "Neba, Rolake A."
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Item Multimorbidity and chronic pain management with opioids and other therapies among adults in the United States: A cross-sectional study(Sage Publications, 2024-03-08) Neba, Rolake A.; Wang, Hao; Kolala, Misozi; Sambamoorthi, UshaBACKGROUND: Multimorbidity, defined as the concurrent presence of >/= 2 chronic conditions, and chronic pain (i.e., pain lasting >/=3 months) often co-exist. Multimodal pain management that includes non-pharmacologic treatment and non-opioid therapy is recommended to prevent serious risks associated with opioids. PURPOSE: Estimate the prevalence of types of pain treatment and analyze their associations with multimorbidity using a nationally representative survey in the United States (US). METHODS: Data was collected from the 2020 National Health Interview Survey among adults with chronic pain and chronic conditions (N= 12,028). Chronic pain management was grouped into four categories: opioid therapy; non-opioid multimodal pain treatment; pain treatment with monotherapy; and no pain treatment. Chi-square tests and multivariable multinomial logistic regressions were used to analyze the association of multimorbidity with types of pain treatment after controlling for age, sex, social determinants of health (SDoH), and lifestyle characteristics. RESULTS: Among NHIS respondents, 68% had multimorbidity. In adjusted multinomial logistic regressions with "pain management with monotherapy" as the reference group, those with multimorbidity were more likely to utilize opioids (AOR=1.63, 95% CI=1.23, 2.17). Those with severe pain were also more likely to use opioid therapy (AOR=19.36, 95% CI=13.35, 28.06) than those with little pain. Those with low income and education were less likely to have multimodal pain management without opioids. CONCLUSION: Seven in 10 adults had multimorbidity. Those with multimorbidity reported severe pain and relied on opioids for pain control. Regardless of multimorbidity status, SDoH was associated with types of chronic pain management.Item Multimorbidity and Whole Health among Adults in the United States: Evidence from the NHIS and BRFSS(2022) Warner, Mayela; Neba, Rolake A.; Manning, Sydney E.; Wiener, Constance; Sambamoorthi, UshaPUPROSE Whole health is a patient-centered approach that promotes self-management of what matters to the patient. Whole health focuses on mind-body, recharge(sleep), healthy diet, emotional health, and movement, all of which are critical for those with multimorbidity. We examined the association of multimorbidity with good whole health among adults in the United States. METHODS We conducted a cross-sectional design. As no one dataset provided information on all components of whole health, we analyzed mind-body therapies, recharge, emotional health, and movement from the 2017 National Health Interview Survey (NHIS), and healthy diet from the 2017 Behavioral Risk Factor Surveillance System (BRFSS). Multimorbidity was defined as the co-occurrence of two or more chronic conditions. Recharge was measured by adequate duration of sleep and the Kessler Psychological Distress Scale (K6) was used to measure emotional health. All unadjusted and adjusted analyses were conducted using the SAS survey procedures. The samples from NHIS (N=25,134) and BRFSS (N=347,029) represented 213 million and 183 million adults, respectively. RESULTS Prevalence of the whole health components varied from 24.4% (mind-body therapies use), 55.7% (healthy-diet), 57.1% (movement), 63.9% (adequate sleep), and good emotional health (78.4%). Based on NHIS, only 3.4% reported good health in all four components. A lower percentage of adults with multimorbidity used mind-body therapies (22.9% vs 25.2%), had adequate sleep (58.2% vs 67.1%), good emotional health (71.8% vs 82.1%), adequate movement (16.2% vs 28.2%), and healthy diet (54.5% vs 56.5%) compared to those without multimorbidity (p < .001). Adjusted analyses revealed that those with multimorbidity were less likely to engage in whole health practices compared to those without multimorbidity. CONCLUSIONS Seven in 10 adults had poor health in two or more components of whole health. Adults with multimorbidity were found to have poorer health in all components of whole health. Nationally representative data surveys should strive to collect information on all components of whole health with standardized measures.Item The Association of Multimorbidity With Whole Health Activities Among Adults in the United States: Evidence From the NHIS and BRFSS(Academic Consortium for Integrative Medicine & Health, 2023-05-08) Neba, Rolake A.; Warner, Mayela; Manning, Sydney E.; Wiener, R. Constance; Sambamoorthi, UshaBACKGROUND: Whole health is a holistic approach encompassing integrative medicine, emotional, and spiritual health and is critical to improving health outcomes among individuals with multimorbidity. OBJECTIVE: To examine the prevalence of Whole Health activities and the association of multimorbidity and Whole Health activities using nationally representative datasets. METHODS: As no single dataset has information on Whole Health self-care activities, data from the 2017 National Health Interview Survey (n = 25 134) was used to measure participants' mind-body therapy usage, sleep, mental health, and physical activity. We used the 2017 Behavioral Risk Factor Surveillance System (n = 347 029) to assess regular vegetable and/or fruit consumption. RESULTS: A significantly lower percentage of adults with multimorbidity had adequate sleep (58.2%vs.67.1%), no psychological distress (71.8%vs.82.1%), adequate physical activity (48.2%vs.62.1%), and regular vegetable and/or fruit consumption (54.2%vs.56.6%) compared to those without multimorbidity. Although lower percentages of adults with multimorbidity utilized mind-body therapies (22.9%vs.25.2%), the association was reversed when adjusted for socioeconomic factors. In the fully adjusted models, adults with multimorbidity were more likely to use mind-body therapies (AOR = 1.19, 95%CI = 1.09, 1.31). Furthermore, when adjusting for other independent variables, the associations of multimorbidity with sleep, psychological distress, and diet were exacerbated, and the association of multimorbidity with physical activity was attenuated. CONCLUSION: Adults with multimorbidity were less likely to engage in most of the Whole Health activities except mind-body therapies compared to the no multimorbidity group. Findings suggest that adjustment for other factors such as age and socioeconomic status changed the magnitude and direction of the association of multimorbidity with Whole Health activities.