Family medicine physicians' views of how to improve chronic pain management
Department of Family Medicine and Community Health
Chronic Disease; Delphi Technique; *Family Practice; Humans; Needs Assessment; Pain; *Physician's Practice Patterns
Life Sciences | Medicine and Health Sciences
PURPOSE: To determine family practice provider views of how to improve chronic nonmalignant pain (CNMP) management in primary care. METHODS: Modified Delphi group process with providers randomly selected from 6 community practice sites: 3 federally qualified community health centers, 1 rural health center, and 2 hospital-owned practices. Providers gave structured written feedback in response to a report of provider and patient concerns about the quality of CNMP in their practice sites and participated in a facilitated discussion in 1 of 3 group meetings. RESULTS: 54% participation (n=14) of family physicians, 6 to 30 years out of residency, identified 4 major themes for improvement of CNMP treatment: (1) the need for provider practice guidelines; (2) changes in the monthly opioid prescription refill process; (3) provision of self-management support and access to alternative treatments for patients; and (4) the use of a nurse care manager. CONCLUSIONS: Family physicians identified multiple components of practice that would improve both provider and patient experiences during and outcomes of CNMP management. Recommendations lend themselves to consideration of CNMP as a chronic illness and use of the Chronic Care Model as an appropriate framework for quality improvement.
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Citation: J Am Board Fam Med. 2007 Sep-Oct;20(5):479-82. Link to article on publisher's site