Factors Associated with Pain Treatment Satisfaction Among Patients with Chronic Non-Cancer Pain and Substance Use

Suen, Leslie W.; McMahan, Vanessa; Rowe, Christopher; Bhardwaj, Sumeet; Knight, Kelly R.; Kushel, Margot; Santos, Glenn-Milo; Coffin, Phillip O.

doi:10.3122/jabfm.2021.06.210214

Cited by 7 publications

(3 citation statements)

References 71 publications

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“…Recent research has shown that patients on long-term opioid therapy for chronic noncancer pain report significantly lower satisfaction with their pain treatment when opioids are discontinued. 18 Our study findings are consistent with the belief that reducing pain intensity through opioid prescribing should not be the ultimate goal of chronic pain management. Opioid prescribing that was not adherent to CPGs may have represented failed efforts to eliminate or minimize chronic pain among the participants in our study.…”

Section: Discussionsupporting

confidence: 89%

Nonadherence to Clinical Practice Guidelines for Opioid Prescribing in Patients with Chronic Low Back Pain: A Pain Research Registry–Based Study

Licciardone

Aryal

2022

J Am Board Fam Med

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Introduction: This study measured the prevalence and impact of nonadherence to clinical practice guidelines (CPGs) that recommend using nonpharmacological and nonopioid treatments such as nonsteroidal anti-inflammatory drugs (NSAIDs) before considering opioids in patients with chronic low back pain.Methods: Participants within the PRECISION Pain Research Registry provided data during the period from April 2016 through October 2021. The prevalence of nonadherence to CPGs was based on current or prior use of 6 common nonpharmacological treatments, NSAIDs, and opioids for low back pain. The primary outcome measures were low back pain intensity, back-related disability, and pain impact on health-related quality of life.Results: The prevalence of nonadherence to CPGs was 68 (18.0%) participants among the 378 participants currently using opioids. Participants having some post-high school education (OR, 0.41; 95% CI, 0.22-0.74) or at least a college education (OR, 0.26; 95% CI, 0.12-0.56) were at decreased risk of treatment that was nonadherent to CPGs in a multivariate analysis. Participants whose treatment was nonadherent to CPGs reported significantly worse clinical outcomes across all 3 measures (P ≤ .001; Cohen's d range, 0.41 to 0.62).Conclusion: Up to one-fifth of patients with chronic low back pain may be prescribed opioids in a manner that is not adherent to CPGs, thereby placing them at risk for poor outcomes.

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Section: Discussionsupporting

confidence: 89%

Nonadherence to Clinical Practice Guidelines for Opioid Prescribing in Patients with Chronic Low Back Pain: A Pain Research Registry–Based Study

Licciardone

Aryal

2022

J Am Board Fam Med

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“…33 Conversely, patients report lower satisfaction with treatment that involves discontinuation of opioids. 23 Our findings pertaining Note: Higher scores represent better physician communication, greater physician empathy, and greater patient satisfaction on the CBQ, CARE, and PSQ-18, respectively, whereas higher scores represent worse outcomes on the NRS for pain intensity, RMDQ for back-related disability, and SPADE cluster for health-related quality-of-life deficits.…”

Section: Discussionmentioning

confidence: 62%

“…18 Perhaps this is because assessing patient satisfaction with treatment of chronic pain is complex, involving various patient populations and differing levels of satisfaction with the process and outcomes of care. 19,20 Some studies of satisfaction with chronic pain care focus on highly selected populations, such as patients with cancer 21,22 or substance abuse, 23 and are not generalizable to the broader population of patients with chronic pain. The purpose of the present study was to measure the associations among process, outcomes, and patient satisfaction within the structural framework of general medical care for chronic low back pain provided via an ongoing patient-physician relationship.…”

mentioning

confidence: 99%

Patient Satisfaction With Medical Care for Chronic Low Back Pain: A Pain Research Registry Study

et al. 2023

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PURPOSEThe process and outcomes of delivering medical care for chronic low back pain might affect patient satisfaction. We aimed to determine the associations of process and outcomes with patient satisfaction. METHODSWe conducted a cross-sectional study of patient satisfaction among adult participants with chronic low back pain in a national pain research registry using self-reported measures of physician communication, physician empathy, current physician opioid prescribing for low back pain, and outcomes pertaining to pain intensity, physical function, and health-related quality of life. We used simple and multiple linear regression models to measure factors associated with patient satisfaction, including a subgroup of participants having both chronic low back pain and the same treating physician for >5 years. RESULTS Among 1,352 participants, only physician empathy (standardized β, 0.638; 95% CI, 0.588-0.688; t = 25.14; P < .001) and physician communication (standardized β, 0.182; 95% CI, 0.133-0.232; t = 7.22; P < .001) were associated with patient satisfaction in the multivariable analysis that controlled for potential confounders. Similarly, in the subgroup of 355 participants, physician empathy (standardized β, 0.633; 95% CI, 0.529-0.737; t = 11.95; P < .001) and physician communication (standardized β, 0.208; 95% CI, 0.105-0.311; t = 3.96; P < .001) remained associated with patient satisfaction in the multivariable analysis.CONCLUSIONS Process measures, notably physician empathy and physician communication, were strongly associated with patient satisfaction with medical care for chronic low back pain. Our findings support the view that patients with chronic pain highly value physicians who are empathic and who make efforts to more clearly communicate treatment plans and expectations.

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The intersection of drug use discrimination and racial discrimination in the management of chronic non-cancer pain in United States primary care safety-net clinics: Implications for healthcare system and clinic-level changes

Cooke

Castellanos²,

Koenders³

et al. 2023

Drug and Alcohol Dependence

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Factors Associated with Pain Treatment Satisfaction Among Patients with Chronic Non-Cancer Pain and Substance Use

Cited by 7 publications

References 71 publications

Nonadherence to Clinical Practice Guidelines for Opioid Prescribing in Patients with Chronic Low Back Pain: A Pain Research Registry–Based Study

Nonadherence to Clinical Practice Guidelines for Opioid Prescribing in Patients with Chronic Low Back Pain: A Pain Research Registry–Based Study

Patient Satisfaction With Medical Care for Chronic Low Back Pain: A Pain Research Registry Study

The intersection of drug use discrimination and racial discrimination in the management of chronic non-cancer pain in United States primary care safety-net clinics: Implications for healthcare system and clinic-level changes

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