Evidence map›Paper›PMID 41933820›Full record

ArticleThe journal of pain2026

Pain psychology service utilization and socioeconomic disparities following telehealth implementation.

Fenan S Rassu, Philip C Huang, Kavya Bhattiprolu, Amy R Li, Kevin J Psoter, Kelly N Daley, Bingqing Ye, Abbey J Hughes, Richard L Skolasky, Stephen T Wegener and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The journal of pain, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Fenan S RassuDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: frassu1@jhmi.edu.
Philip C HuangDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kavya BhattiproluDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Amy R LiDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kevin J PsoterDepartment of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kelly N DaleyDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Bingqing YeDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abbey J HughesDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Richard L SkolaskyDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Stephen T WegenerDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Rachel V AaronDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Funding

Improving Function and Reducing Opioid Use for Patients with Chronic Low Back Pain in Rural Communities through Improved Access to Physical Therapy using TelerehabilitationUH3AR083838 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI Kevin McLaughlin, RICHARD L. SKOLASKY · 2024 to 2026
$3.6M
Optimizing pain-related outcomes following orthopedic trauma: testing novel risk factors and determining the feasibility of a new pain psychology interventionK23HD104934 · NICHD · JOHNS HOPKINS UNIVERSITY · PI Rachel V. Aaron · 2022 to 2026
$756k
Research and Engagement for Advancing Chronic pain Healthcare (REACH)K23MD019351 · NIMHD · JOHNS HOPKINS UNIVERSITY · PI Fenan Rassu · 2024 to 2026
$437k
NIAMS NIH HHS UH3 AR083838NICHD NIH HHS K23 HD104934NIMHD NIH HHS K23 MD019351
6 · The paper itself

Abstract

This natural experiment study examined associations between system-wide telehealth implementation and pain psychology service utilization and socioeconomic disparities among patients with chronic pain. Electronic health record data from 2776 adults referred to a pain psychology clinic were analyzed across two 36-month periods: pre-telehealth (March 2017-February 2020, in-person care) and post-telehealth (April 2020-March 2023, video-based care). Outcomes included evaluation scheduling rates, attendance rates, treatment adherence ratios, and wait times. Socioeconomic indicators were insurance type (Medicaid, Medicare, Commercial, Other) and neighborhood disadvantage (Area Deprivation Index). Multivariable regression models examined period effects and socioeconomic disparities, with interaction analyses testing whether telehealth moderated disparities. Post-telehealth, evaluation scheduling rates decreased (OR=0.82, 95% CI: 0.70-0.97), but treatment attendance ratios significantly improved (median 87.5% vs 72.1% pre-telehealth; β=0.054, 95% CI: 0.014-0.095). Referral-to-evaluation wait times increased overall (β=11.6 days, 95% CI: 4.5-18.8) but decreased specifically for Medicaid patients relative to commercially insured patients (interaction β= -31.2 days (95% CI: -56.5, -5.9); p=0.016). Significant socioeconomic disparities persisted: Medicaid patients had lower evaluation attendance (OR=0.47, 95% CI: 0.32-0.70) and treatment ratios (β=-0.085, 95% CI: -0.156 to -0.014); higher neighborhood disadvantage predicted lower attendance (OR=0.90 per 10-point increase, 95% CI: 0.84-0.95). Telehealth implementation did not moderate most disparities. While the post-telehealth period was associated with improved treatment adherence and reduced specific wait time disparities, fundamental socioeconomic barriers to accessing pain psychology services persisted. PERSPECTIVE: Treatment adherence for pain psychology substantially improved during the post-telehealth period but socioeconomic disparities in access persisted. Findings suggest policies supporting telehealth reimbursement may benefit from being coupled with targeted strategies addressing technology access and systemic barriers for vulnerable populations.

Indexed as

Chronic PainHealthcare DisparitiesPain ManagementPatient Acceptance of Health CareTelemedicineAdultAgedFemaleHumansMaleMiddle AgedSocioeconomic Disparities in HealthUnited StatesChronic painHealth services utilizationPain psychologySocioeconomic disparitiesTelehealth

Identifiers

PMID41933820
PMCPMC13660782

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.