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Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study

BACKGROUND: Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and h...

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Autores principales: Penney, Lauren S., Ritenbaugh, Cheryl, DeBar, Lynn L., Elder, Charles, Deyo, Richard A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5390355/
https://www.ncbi.nlm.nih.gov/pubmed/28403822
http://dx.doi.org/10.1186/s12875-016-0566-0
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author Penney, Lauren S.
Ritenbaugh, Cheryl
DeBar, Lynn L.
Elder, Charles
Deyo, Richard A.
author_facet Penney, Lauren S.
Ritenbaugh, Cheryl
DeBar, Lynn L.
Elder, Charles
Deyo, Richard A.
author_sort Penney, Lauren S.
collection PubMed
description BACKGROUND: Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. METHODS: Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP (n = 90) and primary care providers (PCPs) (n = 25) purposively sampled from a managed care health care system as well as from contracted community A/C providers (n = 14). Focus groups and interviews were conducted patients with CMP with varying histories of A/C use. Plan PCPs and contracted A/C providers took part in individual interviews. All participants were asked about their experiences managing chronic pain and experience with and/or attitudes about A/C treatment. Audio recordings were transcribed and thematically coded. A summarized version of the focus group/interview guides is included in the Additional file 1. RESULTS: We identified four themes around opioid use: (1) attitudes toward use of opioids to manage chronic pain; (2) the limited alternative options for chronic pain management; (3) the potential of A/C care as a tool to help manage pain; and (4) the complex system around chronic pain management. Despite widespread dissatisfaction with opioid medications for pain management, many practical barriers challenged access to other options. Most of the participants’ perceived A/C care as helpful for short term pain relief. We identified that problems with timing, expectations, and plan coverage limited A/C care potential for pain relief treatment. CONCLUSIONS: These results suggest that education about realistic expectations for chronic pain management and therapy options, as well as making A/C care more easily accessible, might lead to more satisfaction for patients and providers, and provide important input to policy makers. TRIAL REGISTRATION: ClinicalTrials.gov NCT01345409, date of registration 28/4/2011 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12875-016-0566-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-53903552017-04-14 Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study Penney, Lauren S. Ritenbaugh, Cheryl DeBar, Lynn L. Elder, Charles Deyo, Richard A. BMC Fam Pract Research Article BACKGROUND: Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. METHODS: Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP (n = 90) and primary care providers (PCPs) (n = 25) purposively sampled from a managed care health care system as well as from contracted community A/C providers (n = 14). Focus groups and interviews were conducted patients with CMP with varying histories of A/C use. Plan PCPs and contracted A/C providers took part in individual interviews. All participants were asked about their experiences managing chronic pain and experience with and/or attitudes about A/C treatment. Audio recordings were transcribed and thematically coded. A summarized version of the focus group/interview guides is included in the Additional file 1. RESULTS: We identified four themes around opioid use: (1) attitudes toward use of opioids to manage chronic pain; (2) the limited alternative options for chronic pain management; (3) the potential of A/C care as a tool to help manage pain; and (4) the complex system around chronic pain management. Despite widespread dissatisfaction with opioid medications for pain management, many practical barriers challenged access to other options. Most of the participants’ perceived A/C care as helpful for short term pain relief. We identified that problems with timing, expectations, and plan coverage limited A/C care potential for pain relief treatment. CONCLUSIONS: These results suggest that education about realistic expectations for chronic pain management and therapy options, as well as making A/C care more easily accessible, might lead to more satisfaction for patients and providers, and provide important input to policy makers. TRIAL REGISTRATION: ClinicalTrials.gov NCT01345409, date of registration 28/4/2011 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12875-016-0566-0) contains supplementary material, which is available to authorized users. BioMed Central 2017-03-24 /pmc/articles/PMC5390355/ /pubmed/28403822 http://dx.doi.org/10.1186/s12875-016-0566-0 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Penney, Lauren S.
Ritenbaugh, Cheryl
DeBar, Lynn L.
Elder, Charles
Deyo, Richard A.
Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study
title Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study
title_full Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study
title_fullStr Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study
title_full_unstemmed Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study
title_short Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study
title_sort provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5390355/
https://www.ncbi.nlm.nih.gov/pubmed/28403822
http://dx.doi.org/10.1186/s12875-016-0566-0
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