Correlates of Health-Care Seeking Activities in Patients with Urological Chronic Pelvic Pain Syndromes: Findings from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Cohort

We examined health-care seeking activities over a 12-month period in a cohort of men and women with urological chronic pelvic pain syndromes (UCPPS).

A total of 191 men and 233 women with UCPPS were followed with biweekly internet-based questionnaires about their symptoms and health-care seeking (HCS) activities, including a) healthcare provider contacts; b) office visits; c) emergency room/urgent care visits; d) medication changes; and e) medical procedures. Multivariable modeling was used to determine the association of demographic and clinical variables with HCS. HCS 'super-users' were defined as individuals who reported HCS activity at least 11 times during the 23 biweekly assessments.

Mean values for HCS activities were 2.4 office contacts, 2.5 office visits, 1.9 medication changes, 0.9 medical procedures, and 0.3 ER/urgent care visits. There were 31 HCS 'super-users' who accounted for 26% of the HCS activities. Worse baseline pain severity and female sex were associated with a higher rate of all HCS activities except ER/urgent care visits. The presence of a non-urologic chronic pain condition was associated with more provider contacts, office visits, and medical procedures. Greater baseline depression symptoms were associated with more provider contacts, office visits, and medication changes. Other examined variables (age, symptom duration, catastrophizing, anxiety, urinary symptom severity, symptom variability) had minimal association with HCS.

HCS activities were strongly influenced by UCPPS pain severity, but not urinary symptom severity. Women and those with non-urologic overlapping pain conditions were more likely to be seen and treated for their symptoms.

The Journal of urology. 2018 Jan 04 [Epub ahead of print]

J Quentin Clemens, Alisa Stephens-Shields, Bruce D Naliboff, H Henry Lai, Larissa Rodriguez, John N Krieger, David A Williams, John W Kusek, J Richard Landis, MAPP Research Network