Assessment and management patterns for chronic musculoskeletal pain in the family practice setting.
Cross-sectional survey
Musculoskeletal pain
Osteoarthritis
Rheumatoid arthritis
primary care
Journal
Journal of bodywork and movement therapies
ISSN: 1532-9283
Titre abrégé: J Bodyw Mov Ther
Pays: United States
ID NLM: 9700068
Informations de publication
Date de publication:
Jul 2024
Jul 2024
Historique:
received:
07
06
2023
revised:
25
01
2024
accepted:
25
02
2024
medline:
15
6
2024
pubmed:
15
6
2024
entrez:
14
6
2024
Statut:
ppublish
Résumé
Chronic pain affects 11% of the US population. Most patients who experience pain, particularly chronic musculoskeletal pain, seek care in primary care settings. Assessment of the patient pain experience is the cornerstone to optimal pain management; however, pain assessment remains a challenge for medical professionals. It is unknown to what extent the assessment of pain intensity is considered in context of function and quality of life. To understand common practices related to assessment of pain and function in patients with chronic musculoskeletal disorders. Cross-sectional survey. A 42-item electronic survey was developed with self-reported numeric ratings and responses related to knowledge, beliefs, and current practices. All physicians and non-physician clinicians affiliated with the AAFP NRN and 2000 AAFP physician members were invited to participate. Primary care clinicians report that chronic joint pain assessment should be comprehensive, citing assessment elements that align with the comprehensive pain assessment models. Pain intensity remains the primary focus of pain assessment in chronic joint pain and the most important factor in guiding treatment decisions, despite well-known limitations. Clinicians also report that patients with osteoarthritis should be treated by Family Medicine. Pain assessment is primarily limited to pain intensity scales which may contribute to worse patient outcomes. Given that most respondents believe primary care/family medicine should be primary responsible for the care of patients with osteoarthritis, awareness of and comfort with existing guidelines, validated assessment instruments and the comprehensive pain assessment models could contribute to delivery of more comprehensive care.
Sections du résumé
BACKGROUND
BACKGROUND
Chronic pain affects 11% of the US population. Most patients who experience pain, particularly chronic musculoskeletal pain, seek care in primary care settings. Assessment of the patient pain experience is the cornerstone to optimal pain management; however, pain assessment remains a challenge for medical professionals. It is unknown to what extent the assessment of pain intensity is considered in context of function and quality of life.
OBJECTIVE
OBJECTIVE
To understand common practices related to assessment of pain and function in patients with chronic musculoskeletal disorders.
DESIGN
METHODS
Cross-sectional survey.
METHODS
METHODS
A 42-item electronic survey was developed with self-reported numeric ratings and responses related to knowledge, beliefs, and current practices. All physicians and non-physician clinicians affiliated with the AAFP NRN and 2000 AAFP physician members were invited to participate.
RESULTS/FINDINGS
RESULTS
Primary care clinicians report that chronic joint pain assessment should be comprehensive, citing assessment elements that align with the comprehensive pain assessment models. Pain intensity remains the primary focus of pain assessment in chronic joint pain and the most important factor in guiding treatment decisions, despite well-known limitations. Clinicians also report that patients with osteoarthritis should be treated by Family Medicine.
CONCLUSIONS
CONCLUSIONS
Pain assessment is primarily limited to pain intensity scales which may contribute to worse patient outcomes. Given that most respondents believe primary care/family medicine should be primary responsible for the care of patients with osteoarthritis, awareness of and comfort with existing guidelines, validated assessment instruments and the comprehensive pain assessment models could contribute to delivery of more comprehensive care.
Identifiants
pubmed: 38876675
pii: S1360-8592(24)00091-3
doi: 10.1016/j.jbmt.2024.02.034
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
50-56Informations de copyright
Copyright © 2024 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest EC – Over the past three years, Dr. Callen received research support from PCORI, Merck, NIH, AAFP Foundation, Otsuka, Takeda, UnitedHealthFoundation, HRSA, GlaxoSmithKline, SAMHSA, Eli Lilly, CDC, HelmsleyFoundation, and VaxCare. CL – Over the past three years, Mr. Lutgen has received research support from PCORI, SAMHSA, Eli Lilly, Shire, Humana, AAFP Foundation, and NCIBH. Mr. Lutgen is also a member of the Governance Committee for the Board of Directors of the North American Primary Care Research Group (NAPCRG). ER – Over the past three years, Ms. Robertson has received research support from NCI, HRSA, SAMHSA, Eli Lilly, Takeda Pharmaceuticals, AHRQ, and CDC. NYL – No interests declared.