Provider and patient perspectives on opioids and alternative treatments for managing chronic pain

a qualitative study

Lauren S. Penney, Cheryl Ritenbaugh, Lynn L. DeBar, Charles Elder, Richard (Rick) Deyo

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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

Original languageEnglish (US)
Article number164
JournalBMC Family Practice
Volume17
Issue number1
DOIs
StatePublished - Mar 24 2017

Fingerprint

Chiropractic
Chronic Pain
Acupuncture
Opioid Analgesics
Pain Management
Musculoskeletal Pain
Interviews
Therapeutics
Focus Groups
Pain
Primary Health Care
Acupuncture Therapy
Managed Care Programs
Administrative Personnel
Patient Satisfaction
Delivery of Health Care
Education
Drug Therapy

Keywords

  • Acupuncture
  • Chiropractic
  • Chronic pain
  • Complementary medicine
  • Opioids
  • Primary care

ASJC Scopus subject areas

  • Family Practice

Cite this

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 (Rick).

In: BMC Family Practice, Vol. 17, No. 1, 164, 24.03.2017.

Research output: Contribution to journalArticle

@article{1ac080f1ce9b467cbe02054519baa202,
title = "Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study",
abstract = "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",
keywords = "Acupuncture, Chiropractic, Chronic pain, Complementary medicine, Opioids, Primary care",
author = "Penney, {Lauren S.} and Cheryl Ritenbaugh and DeBar, {Lynn L.} and Charles Elder and Deyo, {Richard (Rick)}",
year = "2017",
month = "3",
day = "24",
doi = "10.1186/s12875-016-0566-0",
language = "English (US)",
volume = "17",
journal = "BMC Family Practice",
issn = "1471-2296",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Provider and patient perspectives on opioids and alternative treatments for managing chronic pain

T2 - a qualitative study

AU - Penney, Lauren S.

AU - Ritenbaugh, Cheryl

AU - DeBar, Lynn L.

AU - Elder, Charles

AU - Deyo, Richard (Rick)

PY - 2017/3/24

Y1 - 2017/3/24

N2 - 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

AB - 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

KW - Acupuncture

KW - Chiropractic

KW - Chronic pain

KW - Complementary medicine

KW - Opioids

KW - Primary care

UR - http://www.scopus.com/inward/record.url?scp=85018511656&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018511656&partnerID=8YFLogxK

U2 - 10.1186/s12875-016-0566-0

DO - 10.1186/s12875-016-0566-0

M3 - Article

VL - 17

JO - BMC Family Practice

JF - BMC Family Practice

SN - 1471-2296

IS - 1

M1 - 164

ER -