A Comparison of Expectations of Physicians and Patients with Chronic Pain for Pain Clinic Visits

Calpin, Pádraig; Imran, Ather; Harmon, Dominic

doi:10.1111/papr.12428

Cited by 17 publications

(15 citation statements)

References 18 publications

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“…To the best of knowledge, our study is the first to find treatment goal misalignment between paired psoriasis patient–physician using dermatological symptoms as an indicator. Non‐Japanese studies have examined misalignment of disease severity between paired patients and physicians in various disease areas such as atopic dermatitis, rheumatoid arthritis, pain and other disease areas. For psoriasis and psoriatic arthritis, studies on misalignment were mostly on perception of disease severity or treatment satisfaction in paired subjects but the objectives were not on treatment goal.…”

Section: Discussionmentioning

confidence: 99%

Analysis of treatment goal alignment between Japanese psoriasis patients and their paired treating physicians

Okubo

Tsuruta

Tang

et al. 2017

Acad Dermatol Venereol

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BackgroundAppropriate goal‐oriented treatment strategies are important for optimal treatment outcomes and may prevent under‐treatment. As treatment goals vary by patient, a study to examine treatment goals is more meaningful when patients and their physicians are paired. There has not been any study that examines alignment between paired psoriasis patients and physicians in real‐world clinical practice using skin clearance as a treatment goal indicator.ObjectivesTo evaluate treatment goal alignment between psoriasis patients and their paired physicians, and to quantitatively identify factors associated with goal misalignment.MethodsThe study was a nationwide multicenter cross‐sectional observational study. Subjects were physician‐reported moderate‐to‐severe psoriasis patients with a history of systemic treatments, directly paired with their treating physicians. Subjects completed surveys independently. Treatment goals included seven categories, and patient–physician pairs were grouped as ‘aligned’ or ‘misaligned’ when the answers were the same or different, respectively.ResultsA total of 425 pairs (mean response rate, 94.7%) of responses were collected from 54 sites (64.8% general practitioners or clinics; 35.2% university or large hospitals). Treatment goal misalignment was found in 67.9% of the patient–physician pairs. The misalignment was mainly ‘patient predominant’ (60.9%) indicating that patients had higher goals (‘complete clearance’) than physicians. In the multivariate logistic regression analyses, patients’ treatment expectation for ‘complete clearance’ [odds ratio (OR): 1.927; 95% confidential interval (CI): 1.232–3.016] and physician rating of ‘level of understanding on treatment options’ being low (OR: 1.552, 95% CI; 1.082–2.227) were significant factors for treatment goal misalignment.ConclusionsThe majority of treatment goal misalignment was found between paired psoriasis patients and their treating physicians in Japan. The most important contributing factors to misalignment were patients’ treatment expectation for ‘complete clearance’ and physicians’ rating of their patients’ ‘level of understanding on treatment options’ being low.

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Section: Discussionmentioning

confidence: 99%

Analysis of treatment goal alignment between Japanese psoriasis patients and their paired treating physicians

Okubo

Tsuruta

Tang

et al. 2017

Acad Dermatol Venereol

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“…Nevertheless, in spite of this advancement in understanding pain, many attempts still fail to relieve it and improve the quality of the patients’ everyday life. An important element in the effective treatment of pain, especially of the kind not responding to the classic first-line drugs, is to include biological, psychological and social aspects in managing both acute and chronic pain [5,9,10,11,12].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Anxiety, Depression and Aggression in Patients Attending Pain Clinics

Kosson

Malec-Milewska

Gałązkowski

et al. 2018

IJERPH

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The aim of the study was to measure the frequency of such emotional disturbances as anxiety, depression and aggression among patients treated in a pain clinic, as well as assess the factors contributing to such disorders. Research was conducted from January 2014 to April 2018 and involved patients treated in two pain clinics in the city of Warsaw, Poland. The study used the Hospital Anxiety and Depression Scale—Modified Version (HADS-M) and the Numerical Rating Scale (NSR). 1025 patients were recruited. The main reasons for their attending the pain clinic were osteoarticular pain (43.61%) and neuropathic pain (41.56%). Emotional disturbances in the form of anxiety were diagnosed in 32.39% of all the patients, depression in 17.85%, and aggression in 46.15%. The factors determining the level of anxiety in the study group were: sex, age, pain intensity and the lack of pharmacological treatment. Depression was determined by sex, pain intensity and the time of treatment in the clinic, while aggression by age and pain intensity.

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“…The International Association for the Study of Pain (IASP) recommends interdisciplinary treatment of patients with chronic pain, underlining the need to address not only the aspect of the patients’ somatic feelings but also biological, psychological, and social factors in the model of pain management and to implement psychological, social, recreational, and professional training. Pharmacotherapy remains the basic method of treatment, but it should comprise an element of a complex program of rehabilitation, whose final effect is not only to lower pain intensity but also improve the patients’ quality of life and make it possible for them to return to their families and to society [7,8,9,10].…”

Section: Introductionmentioning

confidence: 99%

“…An example of such units are clinics and counseling centers for pain management. Their primary objectives are to treat patients with acute and chronic pain, educate both healthcare personnel and patients, and participate in the preparation of guidelines and research in the field of pain [10,11,12].…”

Section: Introductionmentioning

confidence: 99%

The Effect of the Treatment at a Pain Clinic on the Patients’ Assessment of Their Pain Intensity and the Incidence of Mental Disorders in the form of Anxiety, Depression, and Aggression

Kosson

Kołacz

Gałązkowski

et al. 2019

IJERPH

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The aim of the study was to analyze the effect of the treatment given to patients in a pain clinic on their assessment of pain intensity and the incidence of emotional disturbances in the form of anxiety, depression, and aggression. The study was conducted from January 2014 to April 2018 among patients under the care of two Warsaw pain clinics. The study tools were the Hospital Anxiety and Depression Scale—Modified Version (HADS-M) and the Numerical Rating Scale (NRS). The project enrolled 325 patients, with women comprising 60.62% of patients, and the age bracked of 65–79 years comprising 39.38% of patient. The major reasons for attending the pain clinic were osteoarticular pain (44.92%) and neuropathic pain (42.77%). The therapy applied lowered the patients’ pain intensity (4.98 vs. 3.83), anxiety (8.71 vs. 8.12), aggression (3.30 vs. 3.08), and the overall HADS-M score (18.93 vs. 17.90), which shows that the treatment of both the pain symptoms and the associated emotional disturbances in the form of anxiety and aggression was effective. Sex is a factor affecting pain intensity. The level of mental disorders was influenced by the sex and age of the patients and how long they had been treated in the pain clinics.

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A Comparison of Expectations of Physicians and Patients with Chronic Pain for Pain Clinic Visits

Cited by 17 publications

References 18 publications

Analysis of treatment goal alignment between Japanese psoriasis patients and their paired treating physicians

Analysis of treatment goal alignment between Japanese psoriasis patients and their paired treating physicians

Analysis of Anxiety, Depression and Aggression in Patients Attending Pain Clinics

The Effect of the Treatment at a Pain Clinic on the Patients’ Assessment of Their Pain Intensity and the Incidence of Mental Disorders in the form of Anxiety, Depression, and Aggression

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