SAN ANTONIO – Clinicians in the field vary greatly in their comfort and confidence in assessing and managing chronic pain, according to a survey presented at a poster session at the annual meeting of the American Pain Society.
“Primary care providers are uncomfortable in treating pain and desire help, especially in opioid management,” Dr. William McCarberg, director of the chronic pain management program at Kaiser Permanente in Escondido, Calif., said in an interview. “Specialists are more comfortable but also would like help.”
Recent warnings from the Food and Drug Administration and increased investigations by the Drug Enforcement Agency have helped to create a confusing environment for chronic pain management, he wrote.
The primary objective of the survey was to confirm the perception that there are gaps in education, comfort, and regulatory understanding among practitioners when it comes to prescribing opioids.
A secondary objective was to evaluate physicians' perceived need for improved assessment, management, and documentation of chronic pain.
Physicians in 133 practices (49% primary care physicians, 36% pain specialists, and 15% other), located in five U.S. regions, evaluated their level of knowledge and comfort in assessing and managing patients with chronic pain, using a scale of 1 to 6 (with 1 being “not at all” and 6 being “extremely”). They also rated their interest in additional resources in the areas of time management, patient counseling, and treatment documentation.
“Education was the main concern in primary care,” Dr. McCarberg said. “Regulatory oversight was judged as an issue as well. Primary care practitioners also felt they did not have enough time to take care of pain patients adequately.”
Overall, the pain specialists generally felt more informed on current trends in chronic pain, while the primary care physicians offered far more varied responses, ranging from extremely well informed to very uncomfortable.
A strong interest in greater access to educational tools was observed for both physician education (rated 4.68 by primary care physicians and 5.12 by pain specialists) and patient education (4.82 for primary care and 5.02 for pain specialists), as well as a need for patient counseling resources (5.14 for primary care and 5.39 for pain specialists). Physicians also expressed a strong interest in treatment documentation resources (5.29 for primary care and 5.45 for pain specialists).