Doctor Recommendations are Related to Patient Interest and Use of Behavioral Treatment for Chronic Pain and Addiction

Abstract

The opioid crisis has highlighted the importance of improving patients' access to behavioral treatments for chronic pain and addiction. What is not known is if patients are interested in receiving these treatments. In this cross-sectional study, over 1,000 participants with chronic pain were surveyed using an anonymous online questionnaire on Amazon Mechanical Turk to investigate participants' use of and interest in pharmacological and behavioral treatments for chronic pain and addiction. Participants also indicated whether their doctor had recommended these treatments. The majority of participants reported using medication for their pain (83.19%) and that their doctor recommended medication (85.05%), whereas fewer participants reported using (67.45%) and being recommended to (62.82%) behavioral treatments. We found 63.67% of participants screened positive for possible opioid misuse; those who screened positive were more interested in receiving behavioral treatments than those who did not screen positive. Participants who received treatment recommendations were more likely to be interested in receiving those treatments as compared to participants who did not. The results suggest that recommendations for behavioral treatments and interest in those treatments are related. Results also suggest that patients endorsing behaviors consistent with opioid misuse are interested in behavioral treatments. Perspective: This study provides information around chronic pain patients' treatment interests, treatment receipt, and recommendation receipt for behavioral pain management and addiction treatment. This study could help facilitate communication between patients and doctors regarding available treatments for chronic pain and pain treatment-related addiction problems.

Factors Associated with Interest in Engaging in Psychological Interventions for Pain Management

“…In addition, patients may be more likely to be interested in psychological treatment if their provider has made that recommendation to them. 34 As such, open, early dialog regarding nonpharmacological treatments should be prioritized.…”

“…Therefore, it may be easier to engage patients in psychological treatment before or concurrently prescribing opioids. In addition, patients may be more likely to be interested in psychological treatment if their provider has made that recommendation to them 34 . As such, open, early dialog regarding nonpharmacological treatments should be prioritized.…”

Una revisión sobre la eficacia del tratamiento cognitivo conductual para el abordaje de la comorbilidad de dolor crónico y el consumo problemático de sustancias

“…El uso indebido de opioides y los riesgos de abuso, adicción y sobredosis a los que estarían expuestos este tipo de pacientes ponen en relieve la importancia de prescribir tratamientos comportamentales para el manejo del dolor y adicciones con una frecuencia mayor a la que son recomendados por los médicos (62.82%). 14 En este contexto se considera vital en la valoración inicial del tratamiento en DC incluir, además de la exploración orgánica y abordaje farmacológico, una evaluación de la esfera cognitiva, conductual y afectivo-emocional, así como del impacto laboral y socio-económico. Los estados de Dolor Crónico (DC) no son estáticos, con lo cual la propensión a las adicciones en una población con estados de dolor fluctuantes parece ser un aspecto que requiere tener en cuenta los estados motivacionales en DC.…”

“…12,13 Debido a la propensión a la adicción o uso indebido de sustancias, se vuelve imprescindible una intervención psicoterapéutica eficaz. Recientes estudios llevados a cabo por Brunkow, Cannon, Graff, et al, 14 han valorado la importancia de promover y recomendar tratamientos conductuales en pacientes con DC y consumo de opioides. Alrededor de un 83% de pacientes que padecen DC se encuentran recibiendo tratamiento con opioide, mientras que el 67.45% reportan estar realizando además tratamiento conductual.…”

Virtual Reality as an Adjunct to Ketamine Infusion Therapy Increases Patient Satisfaction in the Management of Chronic Pain and Depression: A Retrospective Pilot Study

“…More than 20% of adults in the United States report experiencing symptoms associated with chronic pain [1]. Unfortunately, effective treatments without severe side effects have proved elusive, as with the treatment of chronic pain associated with the widely reported opioid epidemic [2] [3]. Although opioids show limited long-term efficacy [4] [5], they continue to be widely prescribed, despite the high potential for addiction and overdose [4].…”