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Pain management by primary care physicians, pain physicians, chiropractors, and acupuncturists: a national survey.
South Med J. 2010 Aug; 103(8):738-47.SM

Abstract

OBJECTIVES

Chronic pain is a serious public health problem and is treated by diverse health care providers. In order to enhance policies and programs to improve pain care, we collected information about the distribution of pain patients among four major groups of pain management providers: primary care physicians (PCPs), pain physicians, chiropractors, and acupuncturists, and the variation in the attitudes and practices of these providers with respect to some common strategies used for pain.

METHODS

National mail survey of PCPs, pain physicians, chiropractors, and acupuncturists (ntotal = 3,000).

RESULTS

Eight hundred seventeen responses were usable (response rate, 29%). Analyses weighted to obtain nationally representative data showed that PCPs treat approximately 52% of chronic pain patients, pain physicians treat 2%, chiropractors treat 40%, and acupuncturists treat 7%. Of the chronic pain patients seen for evaluation, the percentages subsequently treated on an ongoing basis range from 51% (PCPs) to 63% (pain physicians). Pain physicians prescribe long-acting opioids such as methadone, antidepressants or anti-convulsants, and other nontraditional analgesics approximately 50-100% more often than PCPs. Twenty-nine percent of PCPs and 16% of pain physicians reported prescribing opioids less often than they deem appropriate because of regulatory oversight concerns. Of the four groups, PCPs are least likely to feel confident in their ability to manage musculoskeletal pain and neuropathic pain, and are least likely to favor mandatory pain education for all PCPs.

CONCLUSIONS

There is substantial variation in attitudes and practices of the various disciplines that treat chronic pain. This information may be useful in interpreting differences in patient access to pain care, planning studies to clarify patient outcomes in relation to different providers and treatment strategies, and designing a system that matches chronic pain patients to appropriate practitioners and treatments.

Authors+Show Affiliations

Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY 10003, USA. bbreuer@chpnet.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20622716

Citation

Breuer, Brenda, et al. "Pain Management By Primary Care Physicians, Pain Physicians, Chiropractors, and Acupuncturists: a National Survey." Southern Medical Journal, vol. 103, no. 8, 2010, pp. 738-47.
Breuer B, Cruciani R, Portenoy RK. Pain management by primary care physicians, pain physicians, chiropractors, and acupuncturists: a national survey. South Med J. 2010;103(8):738-47.
Breuer, B., Cruciani, R., & Portenoy, R. K. (2010). Pain management by primary care physicians, pain physicians, chiropractors, and acupuncturists: a national survey. Southern Medical Journal, 103(8), 738-47. https://doi.org/10.1097/SMJ.0b013e3181e74ede
Breuer B, Cruciani R, Portenoy RK. Pain Management By Primary Care Physicians, Pain Physicians, Chiropractors, and Acupuncturists: a National Survey. South Med J. 2010;103(8):738-47. PubMed PMID: 20622716.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pain management by primary care physicians, pain physicians, chiropractors, and acupuncturists: a national survey. AU - Breuer,Brenda, AU - Cruciani,Ricardo, AU - Portenoy,Russell K, PY - 2010/7/13/entrez PY - 2010/7/14/pubmed PY - 2010/8/31/medline SP - 738 EP - 47 JF - Southern medical journal JO - South Med J VL - 103 IS - 8 N2 - OBJECTIVES: Chronic pain is a serious public health problem and is treated by diverse health care providers. In order to enhance policies and programs to improve pain care, we collected information about the distribution of pain patients among four major groups of pain management providers: primary care physicians (PCPs), pain physicians, chiropractors, and acupuncturists, and the variation in the attitudes and practices of these providers with respect to some common strategies used for pain. METHODS: National mail survey of PCPs, pain physicians, chiropractors, and acupuncturists (ntotal = 3,000). RESULTS: Eight hundred seventeen responses were usable (response rate, 29%). Analyses weighted to obtain nationally representative data showed that PCPs treat approximately 52% of chronic pain patients, pain physicians treat 2%, chiropractors treat 40%, and acupuncturists treat 7%. Of the chronic pain patients seen for evaluation, the percentages subsequently treated on an ongoing basis range from 51% (PCPs) to 63% (pain physicians). Pain physicians prescribe long-acting opioids such as methadone, antidepressants or anti-convulsants, and other nontraditional analgesics approximately 50-100% more often than PCPs. Twenty-nine percent of PCPs and 16% of pain physicians reported prescribing opioids less often than they deem appropriate because of regulatory oversight concerns. Of the four groups, PCPs are least likely to feel confident in their ability to manage musculoskeletal pain and neuropathic pain, and are least likely to favor mandatory pain education for all PCPs. CONCLUSIONS: There is substantial variation in attitudes and practices of the various disciplines that treat chronic pain. This information may be useful in interpreting differences in patient access to pain care, planning studies to clarify patient outcomes in relation to different providers and treatment strategies, and designing a system that matches chronic pain patients to appropriate practitioners and treatments. SN - 1541-8243 UR - https://www.unboundmedicine.com/medline/citation/20622716/Pain_management_by_primary_care_physicians_pain_physicians_chiropractors_and_acupuncturists:_a_national_survey_ L2 - http://dx.doi.org/10.1097/SMJ.0b013e3181e74ede DB - PRIME DP - Unbound Medicine ER -