Assessment of the Management of Patients with Chronic Pain Referred to a Specialized Pain Unit: A Cross-Sectional Multicenter Study (the DUO Project) (original) (raw)
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A Survey of Perceptions with Pain Management in Spanish Inpatients
Journal of Pain and Symptom Management, 2006
The aim of this study was to document the satisfaction with pain management in a Spanish inpatient population and its relationship with pain ratings. Two hundred fifty inpatients of four departments were interviewed: Surgery, Orthopedics, Gynecology, and Internal Medicine. A 32-item questionnaire was used, and the main variables evaluated were pain severity, dissatisfaction with pain management and caregivers, and patient expectations regarding pain relief. Relationships among the variables were analyzed by means of Spearman's correlation between item scores and regression analysis. Median satisfaction scores were consistent with "very satisfied." Mean (SD) worst pain during the past 24 hours was 68.8 (27.5) on a 100 mm visual analogue scale. "Dissatisfaction with Pain Management" correlated positively with "Dissatisfaction with Medical Staff" (0.42), and inversely with "Pain Now" (-0.41) and "Expected Pain Relief" (-0.38). Regression analysis showed that "Dissatisfaction with Pain Management" was dependent on "Pain Now," "Least Pain," and "Dissatisfaction with Medical Staff," with statistically significant beta weight values of 0.277, 0.197, and 0.280, respectively. The study shows that patients were highly satisfied with pain management, even when they were in pain. Moreover, it establishes that patient dissatisfaction with treatment was highly related to the satisfaction with caregivers and pain intensity.
KNOWLEDGE AND PRACTICE IN CHRONIC PAIN MANAGEMENT AMONGPRIMARY HEALTHCARE PHYSICIANS
Objective: To evaluatethe knowledge and practice in chronic pain management among primary healthcare physicians (PHCPs). Methods: Across-sectional questionnaire-based study was carried out in a selected 15 primary healthcare centers in Jeddah, Saudi Arabiafrom October 15, 2016 to November 15, 2016.An auto-questionnaire was administered.The outcome measures included clinical practice score (CPS; range 20-100) and confidence level score (CLS; range 20-100). Results:Physicians’ practice showed a mean±SD (range) CPS=76.13±15.12 (41.11; 100.00). Most frequently assessed parameters included topography of the pain; followed by prior medications and physical impact. Less frequently assessed parameters included underlying cause, psychological impact and pain onset time.Frequent physical examinationsassessed the painful area; followed by general physical exam and inflammation signs. Less frequentexaminationsscreened for neuropathic pain component and motor and sensory abnormalities. Physicians in high patient-flow centers (?30 patients seen per day) had lower CPS. Physicians’ confidence in chronic pain management showed a CLS=69.60±16.61 (30.00; 100.00). Physicians declared being less confident of cancer chronic pain management,use of antidepressants, non-cancer chronic pain management,and use of anticonvulsant drugs. Higher CLS was reported in family physicians (CLS=82.18±15.60) as compared to pediatrics (73.50±14.09) and general medicine (62.62±15.17); (p=0.000001). CLS was proportional to age and experience. Conclusion: Relatively insufficient practice and low levels of confidence among physicians regarding all aspects of chronic pain management was reported. Employing national or local protocols can be useful.
Current Medical Research and Opinion, 2012
Objectives: This survey explores how physicians perceive chronic non-cancer pain, and examines their opinions on current treatment options. Methodology: The computer-based survey comprises a questionnaire that is completed by physicians, mostly at professional conferences and congresses, but also online. The focus is on pain specialists, primary care physicians and other specialists (such as neurologists and rheumatologists), to discover any differences in their approach to treating chronic non-cancer pain. Results: No common understanding existed of where severe pain starts on an 11-point Numeric Rating Scale. Overall, two-thirds of respondents aim for treatment to reduce pain intensity to an NRS score of 2-4, with primary care physicians tending to aim for lower scores. All three groups considered reduction of pain to be the most important treatment goal, followed by quality of life. Asked to rank the most important factors when choosing an analgesic agent to treat severe, chronic noncancer pain, respondents ranked efficacy first, tolerability second, and quality of life third. In each rank, more primary care physicians chose these options than in the specialist groups. More pain specialists used classical strong opioids often or very often-and for longer-than did physicians in the other two groups. Nausea/vomiting, bowel dysfunction and somnolence were ranked the first, second and third main reasons, respectively, for treatment failure with these agents. Over 90% of respondents used combination treatment rather than monotherapy to treat severe, chronic pain, but no fewer than 176 different combinations were cited. Conclusions: Pain reduction and improvement in quality of life are the most important treatment goals. Wide variation in treatment indicates that no single drug is particularly good for managing chronic pain, and suggests that current treatment is not evidence-based. Differences between the groups imply that first-line treatment is more cautious and conventional. The key limitations of this survey include its small sample size, informal implementation and lack of detail regarding the respondents surveyed.