Chronic nonmalignant pain in primary care

Robert Jackman, Janey M. Purvis, Barbara S. Mallett

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

A systematic approach to chronic nonmalignant pain includes a comprehensive evaluation; a treatment plan determined by the diagnosis and mechanisms underlying the pain; patient education; and realistic goal setting. The main goal of treatment is to improve quality of life while decreasing pain. An initial comprehensive pain assessment is essential in developing a treatment plan that addresses the physical, social, functional, and psychological needs of the patient. One obstacle to appropriate pain management is managing the adverse effects of medication. Opioids pose challenges with abuse, addiction, diversion, lack of knowledge, concerns about adverse effects, and fears of regulatory scrutiny. These challenges may be overcome by adherence to the Federation of State Medical Boards guidelines, use of random urine drug screening, monitoring for aberrant behaviors, and anticipating adverse effects. When psychiatric comorbidities are present, risk of substance abuse is high and pain management may require specialized treatment or consultation. Referral to a pain management specialist can be helpful.

Original languageEnglish (US)
JournalAmerican Family Physician
Volume78
Issue number10
StatePublished - Nov 15 2008

Fingerprint

Chronic Pain
Primary Health Care
Pain Management
Referral and Consultation
Pain
Preclinical Drug Evaluations
Drug Monitoring
Patient Education
Pain Measurement
Therapeutics
Opioid Analgesics
Fear
Substance-Related Disorders
Psychiatry
Comorbidity
Quality of Life
Urine
Guidelines
Psychology

ASJC Scopus subject areas

  • Family Practice

Cite this

Jackman, R., Purvis, J. M., & Mallett, B. S. (2008). Chronic nonmalignant pain in primary care. American Family Physician, 78(10).

Chronic nonmalignant pain in primary care. / Jackman, Robert; Purvis, Janey M.; Mallett, Barbara S.

In: American Family Physician, Vol. 78, No. 10, 15.11.2008.

Research output: Contribution to journalArticle

Jackman, R, Purvis, JM & Mallett, BS 2008, 'Chronic nonmalignant pain in primary care', American Family Physician, vol. 78, no. 10.
Jackman, Robert ; Purvis, Janey M. ; Mallett, Barbara S. / Chronic nonmalignant pain in primary care. In: American Family Physician. 2008 ; Vol. 78, No. 10.
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