When it comes to pain treatment, doctors and patients are often not on the same page, according to a new study.
“We wanted to understand why discussions about pain between patients and doctors are often contentious and unproductive,” said lead author Stephen Henry, M.D., an assistant professor of internal medicine at UC Davis. “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.”
Based on the findings that physicians and patients are often at odds when it comes to treatment goals, researchers recommend pain-focused communication training for doctors to help bridge the gap, according to the study (PDF) published in The Clinical Journal of Pain.
Disagreements between doctors and patients over the priorities of pain treatment are common during primary care office visits, the research found. Patients’ goals are to reduce pain intensity (48%) and identify the cause (22%), while physicians hope to improve a patient’s physical function (41%) and reduce medication side effects (26%), including dependency on painkillers.
The study focused on 87 patients receiving opioid prescriptions for chronic musculoskeletal pain and 49 internal or family medicine physicians in two UC Davis Medical Center clinics in Sacramento. Both doctors and physicians completed questionnaires following patient visits about their goals for pain management.
Training should focus on ensuring physicians have the medical skills to effectively and safely treat pain, along with better communication skills, Henry said. That is important given state and federal guidelines issued in light of the epidemic of opioid abuse and overdose deaths. While primary care physicians may have adapted to those new recommendations that emphasize functional goals and avoiding long-term opioid therapy, patients continue to focus on reducing pain intensity, the researchers said.