Doctors and patients often do not see eye-to-eye when it comes to treatment of chronic pain, according to researchers at the University of California at Davis.
A new study by UC Davis Health suggests patients and doctors often disagree about the goals of pain treatment, with doctors aiming to improve physical function and reduce medication side effects such as dependency while patients want to reduce pain intensity and identify the cause.
“We wanted to understand why discussions about pain between patients and doctors are often contentious and unproductive,” Stephen Henry, assistant professor of internal medicine at UC Davis, said in a press release. “Primary care physicians treat the majority of patients with chronic pain, but they aren’t always equipped to establish clear, shared treatment goals with their patients.”
The study included 87 patients receiving opioid prescriptions for chronic musculoskeletal pain and 49 internal or family medicine physicians from two UC Davis Medical Center clinics who filled out questionnaires immediately following their visits from November 2014 to January 2016.
The questionnaires asked patients to rate their experiences and goals for pain management, while physicians were asked to complete a separate questionnaire about the level of visit difficulty and their own rankings of goals for the patient’s pain management.
Researchers discovered 48 percent of patients ranked reducing pain intensity as their number one priority, while 22 percent ranked finding the cause of the pain as their top priority. Physicians ranked improving function as their top priority for 41 percent of patients and reducing medication side effects as the most important for 26 percent.
The study showed that in 62 percent of visits, the physician’s first-and second treatment priority were not the same as the patient’s top priority.
Physicians also rated 41 percent of the patient visits as “difficult,” while patients rated their doctors’ office experience as positive.
“We need to make sure physicians have the medical skills it takes to effectively and safely treat pain, as well as the communications skills needed to discuss treatment goals and navigate instances when they don’t see eye-to-eye with patients,” Henry said.
The study was published in the Clinical Journal of Pain.