Pain Diagnostics and Interventional Care, Sewickley, Pennsylvania.
School of Pharmacy and Graduate School of Pharmaceutical Sciences Division of Pharmaceutical, Administrative and Social Sciences Duquesne University, Duquesne University.
Pain Physician. 2018 Nov;21(6):E593-E602.
The management of chronic pain is complex and often involves the integration of multiple clinical, humanistic, and economic factors. Primary care physicians (PCPs) are often at the forefront of managing chronic pain and often initiate pharmacological pain management therapy. To date little is known surrounding the pain management practices of PCPs.
The purpose of this study is to assess the knowledge and practice of PCPs in management of chronic pain.
A survey.
Western region of Pennsylvania, US.
A cross-sectional questionnaire survey evaluated PCPs pain management treatment practices including assessment of chronic pain, procedural activities surrounding therapy, decision-making input, and knowledge for therapeutic pain management including the 5 main classes of medications. The questionnaire was developed based on a review of the literature including published chronic pain guidelines. The questionnaire was mailed to a convenience sample of 300 PCPs practicing in Western Pennsylvania. The study was approved by the University Institutional Review Board.
The survey had a response rate of 16%. The respondents on average treated 30 chronic pain patients per month predominately in a community setting. The most common conditions treated included osteoarthritis, back and neuropathic pain. Although the major reported source of education was published literature, only 67% respondents referred to pain management guidelines. Multiple knowledge and practice gaps were identified surrounding pharmacological treatment, medication management including compliance practices, and pain assessment.
Although low, the response rate is comparable to response rates for other chronic pain management topics including anticoagulation and prescription patterns for chronic pain physicians. Also, greater than 50% of the respondents were from private practice, therefore, the results may not pertain to other practice settings including academic and hospital-based practices.
The survey provided significant insight into PCP practices and highlights areas for future educational efforts. Further opioid prescribing education would be beneficial especially regarding the utilization of opioid risk assessment tools, the selection of opioids, and opioid end organ effects. Furthermore, patient education on the realities of chronic pain management and the importance of nonpharmacological treatment are needed in order to reduce the challenges faced by PCPs surrounding chronic pain management.
Chronic pain, primary care physician, pain management, survey questionnaire.
慢性疼痛的管理较为复杂，通常需要综合考虑多种临床、人文和经济因素。初级保健医生（PCP）通常处于管理慢性疼痛的最前线，并且经常会启动药物治疗疼痛管理。迄今为止，人们对 PCP 管理疼痛的实践知之甚少。
本研究旨在评估 PCP 管理慢性疼痛的知识和实践。
调查。
美国宾夕法尼亚州西部地区。
横断面问卷调查评估了 PCP 疼痛管理治疗实践，包括对慢性疼痛的评估、治疗相关的程序活动、决策投入以及治疗疼痛管理的知识，包括 5 大主要类别的药物。问卷基于文献综述和已发表的慢性疼痛指南制定。该问卷以便利抽样的方式寄给了在宾夕法尼亚州西部地区执业的 300 名 PCP。该研究得到了大学机构审查委员会的批准。
调查的回复率为 16%。受访者平均每月治疗 30 名慢性疼痛患者，主要在社区环境中进行治疗。最常见的治疗疾病包括骨关节炎、背部和神经病理性疼痛。尽管主要的教育来源是已发表的文献，但只有 67%的受访者参考了疼痛管理指南。在药物治疗、药物管理（包括依从性实践）和疼痛评估方面，发现了多种知识和实践差距。
尽管回复率较低，但与其他慢性疼痛管理主题（包括抗凝和慢性疼痛医生的处方模式）的回复率相当。此外，超过 50%的受访者来自私人诊所，因此，结果可能不适用于其他实践环境，包括学术和医院实践。
该调查提供了对 PCP 实践的深入了解，并突出了未来教育努力的方向。进一步的阿片类药物处方教育将是有益的，特别是在使用阿片类药物风险评估工具、选择阿片类药物和阿片类药物终末器官效应方面。此外，需要对患者进行慢性疼痛管理的现实和非药物治疗重要性的教育，以减少 PCP 在慢性疼痛管理方面面临的挑战。
慢性疼痛，初级保健医生，疼痛管理，问卷调查。
