Providers' Role in Building Patient Buy-In for Treating Chronic Pain and PTSD: Veterans' Perspectives on Interactions with Providers.

BACKGROUND

Patients with co-occurring chronic pain and PTSD are especially vulnerable to debilitating symptoms and frustrating experiences seeking healthcare. The complicated nature of the health conditions and their treatments present a challenge for providers to communicate their treatment recommendations and rationale.

OBJECTIVE

This qualitative study explored Veterans' views on communication with their providers during clinical visits related to their chronic pain and PTSD treatments, so that we may understand their experiences and identify opportunities to improve clinical communication and patient satisfaction.

DESIGN

Semi-structured interviews with the interview guide finalized based on feedback from a Veteran engagement panel.

PARTICIPANTS

Veterans diagnosed with chronic pain and PTSD who receive care from Veterans Health Administration.

APPROACH

Inductive thematic analysis to characterize how Veterans describe interactions with providers treating their chronic pain and PTSD.

KEY RESULTS

Providers' communication influences Veterans' perceptions in three ways: (a) when Veterans expressed satisfaction with their provider, they described their gratitude for learning about their options; (b) when Veterans expressed dissatisfaction, it often represented a lack of mutual understanding or knowledge of the provider's rationale; and (c) inaccurate information on electronic medical records perpetuated a distrustful environment.

CONCLUSIONS

Breakdowns occur when Veterans are unsure of their providers' rationale and our data underscore the importance of clear communication in establishing trust and optimizing care for Veterans with PTSD and chronic pain. As the interplay between chronic pain and PTSD symptoms takes centerstage in clinical innovations, providers must consider how best to educate their patients and explain their rationale for recommendations. Trauma-informed strategies may be especially valuable for delivering care to an inordinately vulnerable population.