Table 5.

Associations between pain-related variables and physician-reported visit difficulty^a

	Bivariate analysisb			Adjusted analysisc
Communication during visits	Coefficient	95% CI	P-value	Coefficient	95% CI	P-value
Patient requests for increased opioid dose	2.28	1.21, 3.35	<0.001	1.83	0.87, 2.79	<0.001
Patient requests for information	0.54	0.22, 0.86	0.001	0.51	0.25, 0.76	<0.001
Patient requests that physicians take some action	0.41	−0.01, 0.82	0.06	0.22	−0.19, 0.64	0.29
Patient negative assessment of pain	0.31	0.05, 0.58	0.02	0.31	0.10, 0.53	0.004
Physician recommendation for opioid dose decrease	0.32	−0.38, 1.01	0.37	0.11	−0.67, 0.88	0.79
Physician patient-centered communication	−0.02	−0.28, 0.25	0.91	−0.03	−0.26, 0.20	0.80
Patient-physician disagreement	0.90	0.56, 1.23	<0.001	0.71	0.39, 1.03	<0.001
Length of discussion of opioid risks and side effects	0.76d	0.08, 1.45	0.03	0.60	−0.06, 1.26	0.07
Patient characteristics
Pain severity	1.87	0.79, 2.95	0.001	1.59	0.57, 2.62	0.002
Pain catastrophizing	0.37	0.09, 0.66	0.01	0.24	−0.02, 0.50	0.07
Risk of opioid misuse	0.81d	0.00, 1.63	0.05	0.03	−0.79, 0.85	0.94
Desire for increased pain medicine	2.56	1.22, 3.89	<0.001	2.31	1.03, 3.59	<0.001
VR-12 mental component score	−0.19	−0.36, −0.02	0.03	−0.14	−0.30, 0.03	0.10
VR-12 physical component score	−0.11	−0.46, 0.24	0.54	−0.09	−0.41, 0.24	0.60

^adifficulty ratings range from 10–60, with higher values indicating greater difficulty

^bcontrolled only for clustering (generalized estimating equations)

^ccontrolled for clustering, age, and whether patient had documentation of substance use disorder

^dresults not significant (P < 0.05) after removing 2 outliers that involve major opioid-related conflict