Between 11% to 40% of adults in the United States experience chronic pain, and primary care physicians may feel ill-equipped to effectively and safely care for patients with chronic pain, addiction or both. Researchers from Tufts University conducted a study to evaluate the effectiveness of an interdisciplinary consultation service that supports primary care physicians who care for patients experiencing chronic pain and addiction. The goal was to identify new and effective strategies that clinics can use to support PCPs.
From that interdisciplinary consultation service, the researchers collected and thematically analyzed 66 referral questions and 14 interviews with PCPs to better understand the types of support physicians would find most beneficial.
PCPs' expressed needs included needing expertise in addiction, safe prescribing of opioids, non-opioid treatment options, communication strategies for difficult conversations, a comprehensive review of the case, and a biopsychosocial approach to management. Some additional needs were identified after interviews, including confirmation of their medical decision-making process, emotional validation, feeling more control, having an outside entity take the burden off the PCP for management decisions, boundary setting and reframing the visit to focus on the patient's function, values and goals.
The authors concluded that an interdisciplinary consultation service can effectively support primary care physicians who care for patients battling pain and addiction. They then offer some potential strategies that health systems can use to support PCPs in this important role.
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Multidisciplinary Approach for Managing Complex Pain and Addiction in Primary Care: A Qualitative Study
Randi Sokol, MD, MPH, MMedEd, et al, Department of Family Medicine, Tufts University School of Medicine, Boston, Massachusetts
https://www.annfammed.org/content/19/3/224
Journal
The Annals of Family Medicine