Patient preferences in the treatment of chronic musculoskeletal pain: a systematic review of discrete choice experiments

Zhu, Min; Dong, Dong; Lo, Hermione Hin-Man; Wong, Samuel Yeung‐Shan; Mo, Phoenix K. H.; Sit, Regina W.S.

doi:10.1097/j.pain.0000000000002775

Cited by 3 publications

(2 citation statements)

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“…Those utilizing emergency services for pain are more likely to have worse chronic pain and psychological wellbeing (94). Few hospital settings offer pain education or behavioral pain care prior to or following surgical procedures, even though there is evidence that brief behavioral interventions can lower healthcare expenditures and improve surgical outcomes (95). Primary barriers include poor insurance coverage, high out-of-pocket costs, and the lack of flexible, patient-centered treatments that can scale within these settings (96).…”

Section: Discussionmentioning

confidence: 99%

“…Few hospital settings offer pain education or behavioral pain care prior to or following surgical procedures, even though there is evidence that brief behavioral interventions can lower healthcare expenditures and improve surgical outcomes ( 95 ). Primary barriers include poor insurance coverage, high out-of-pocket costs, and the lack of flexible, patient-centered treatments that can scale within these settings ( 96 ). Several treatments detailed, including Empowered Relief ( 52 , 56 ) and WebMap ( 49 ), may be viable pain treatments that could be freely available and easily integrated into a variety of medical settings.…”

Section: Discussionmentioning

confidence: 99%

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Innovative treatment formats, technologies, and clinician trainings that improve access to behavioral pain treatment for youth and adults

et al. 2023

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Chronic pain is prevalent across the life span and associated with significant individual and societal costs. Behavioral interventions are recommended as the gold-standard, evidence-based interventions for chronic pain, but barriers, such as lack of pain-trained clinicians, poor insurance coverage, and high treatment burden, limit patients’ ability to access evidenced-based pain education and treatment resources. Recent advances in technology offer new opportunities to leverage innovative digital formats to overcome these barriers and dramatically increase access to high-quality, evidenced-based pain treatments for youth and adults. This scoping review highlights new advances. First, we describe system-level barriers to the broad dissemination of behavioral pain treatment. Next, we review several promising new pediatric and adult pain education and treatment technology innovations to improve access and scalability of evidence-based behavioral pain treatments. Current challenges and future research and clinical recommendations are offered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Innovative treatment formats, technologies, and clinician trainings that improve access to behavioral pain treatment for youth and adults

et al. 2023

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A discrete choice experiment: Understanding patient preferences for managing chronic non‐cancer pain

Campbell,

Settumba,

Hopkins

et al. 2024

European Journal of Pain

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BackgroundThe management of chronic non‐cancer pain (CNCP) is complex. Concerns about adverse effects associated with opioid pain medications and a lack of funding for holistic programs present challenges for decision‐making among clinicians and patients. Discrete choice experiments (DCE) are one way of assessing and valuing patient treatment preferences.MethodDCE attributes and levels were generated through qualitative research and included number of medicines, side effects from medicines, pain interference, care management, risk of addiction, activity goals, preferred source of information on pain management and willingness to pay. The survey was administered to participants with CNCP recruited through an existing cohort study (n = 442) and a sample of people living with CNCP recruited through Australia's leading pain advocacy body (Painaustralia) (n = 256).ResultsThe median age of participants was 58 years (SD 12.0), the majority were female. The analysis revealed two latent demographic classes: a younger group with higher levels of private health insurance and an older group with lower levels of private health insurance coverage. There were notable differences in preference. The younger cohort exhibited a greater willingness‐to‐pay to reduce pain interference, whereas the older group prioritized GP management, preferred more medicines and expressed fewer addiction concerns.ConclusionPatients' treatment preferences diverged based on age and insurance status, underscoring the importance of understanding patient perspectives in treatment communication and care coordination. These findings provide insight into patient decision‐making, which is important for promoting access to quality healthcare and engagement with evidence‐based treatment of CNCP.Significance StatementA discrete choice experiment identified two groups: younger, with more private insurance, and older, with less private health insurance, each with unique pain management preferences. Clinicians should be aware that age and private health insurance may have an impact on a patient's preferences for CNCP management.

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Developing attributes and attribute-levels for subacromial pain syndrome: A systematic review and qualitative study

Tróndarson,

Storgaard,

Larsen

et al. 2024

Pain Medicine

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Background Subacromial pain syndrome (SAPS), the most common cause of shoulder pain, can be treated through different treatments with similar effects. Therefore, in terms of deciding on the right treatment fit, patient preferences need to be understood. We aimed to identify treatment characteristics that delineate interventions (attributes) and corresponding sets of specific categorical range (attribute-levels) for SAPS. Methods This multiple method study systematically reviewed both qualitative and quantitative studies on patient preferences for treatment of SAPS, which informed semi-structured interviews with nine clinicians and 14 patients. The qualitative data from the interviews was analyzed using the framework analysis formulated by Ritchie and Spencer. Attributes and attribute levels of the systematic review and interviews were summarized and categorized. Results The search resulted in 2.607 studies, 16 of which met the eligibility criteria. The review identified 120 potential attributes, which were synthesized into 25 potential attributes. Fourteen new potential attributes were identified through the interviews, equaling a total of 39 attributes across 11 categories. Levels for 37 attributes were identified through systematic review and interviews, we were unable to identify levels for two attributes. Conclusions This study identified attributes and attribute levels for the treatment of SAPS. There was a discrepancy in the frequency of the represented attributes between the literature and interviews. This study may improve the understanding of patient preferences for the treatment of SAPS and help individualize care. Our study informs a future discrete choice experiment and supports shared decision-making in clinical practice.

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Patient preferences in the treatment of chronic musculoskeletal pain: a systematic review of discrete choice experiments

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 3 publications

References 57 publications

Innovative treatment formats, technologies, and clinician trainings that improve access to behavioral pain treatment for youth and adults

Innovative treatment formats, technologies, and clinician trainings that improve access to behavioral pain treatment for youth and adults

A discrete choice experiment: Understanding patient preferences for managing chronic non‐cancer pain

Developing attributes and attribute-levels for subacromial pain syndrome: A systematic review and qualitative study

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