Contrasting Tensions Between Patients and PCPs in Chronic Pain Management: A Qualitative Study. Issue 11 (19th July 2013)

• Record Type: Journal Article
• Authors: Bergman, Alicia A.; Matthias, Marianne S.; Coffing, Jessica M.; Krebs, Erin E.
• Is Part Of: Pain medicine. Volume 14:Issue 11(2013)
• Page Start: 1689
• Page End: 1697
• Publication Date: 2013-07-19
• Subjects: Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesics -- Periodicals; Pain -- Periodicals; Pain Management -- Periodicals; Douleur -- Périodiques; Douleur -- Traitement -- Périodiques; Analgésiques -- Périodiques; Analgésique; Soulagement de la douleur; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.047205
• DOI: 10.1111/pme.12172
• Languages: English
• ISSNs: 1526-2375

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="pme12172-sec-0001" sec-type="section"> <title>Objective</title> <p>With greater scrutiny on primary care providers' (PCPs) approaches to chronic pain management, more research is needed to clarify how concerns and uncertainties about opioid therapy affect the ways both patients with chronic pain and PCPs experience primary care interactions. The goal of this qualitative study was to develop a better understanding of the respective experiences, perceptions, and challenges that patients with chronic pain and PCPs face communicating with each other about pain management.</p> </sec> <sec id="pme12172-sec-0002" sec-type="section"> <title>Design</title> <p>Purposive and snowball sampling techniques were used to identify 14 PCPs. Patients who received ≥6 opioid prescriptions during the prior year were selected at random from the panels of participating physicians. Face‐to‐face in‐depth interviews were conducted individually with patients and PCPs.</p> </sec> <sec id="pme12172-sec-0003" sec-type="section"> <title>Setting</title> <p>VISN 11 Roudebush VA Medical Center (RVAMC) in Indianapolis, Indiana.</p> </sec> <sec id="pme12172-sec-0004" sec-type="section"> <title>Subjects</title> <p>Fourteen PCPs and 26 patients with chronic pain participated.</p> </sec> <sec id="pme12172-sec-0005" sec-type="section"> <title>Methods</title> <p>An inductive thematic analysis was conducted separately with patient and PCP interview data, after which the emergent themes for both groups were compared and contrasted.</p> </sec> <sec id="pme12172-sec-0006" sec-type="section"> <title>Results</title> <p>Three notable tensions between patients and PCPs were discovered: 1) the role of discussing pain versus other primary care concerns, 2) acknowledgment of pain and the search for objective evidence, and 3) recognition of patient individuality and consideration of relationship history.</p> </sec> <sec id="pme12172-sec-0007" sec-type="section"> <title>Conclusions</title> <p>Competing demands of primary care practice, differing beliefs about pain, and uncertainties about the appropriate place of opioid therapy in chronic pain management likely contributed to the identified tensions. Several clinical communication strategies to help PCPs mitigate and manage pain‐related tensions are discussed.</p> </sec> </abstract>