Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study

作者：Lauren Penney, Cheryl Ritenbaugh, Lynn DeBar, Charles R. Elder, Richard A. Deyo · 发表于：BMC Family Practice · 年份：2016 · DOI：10.1186/s12875-016-0566-0 · 被引用次数：99 · 研究领域：Musculoskeletal pain and rehabilitation、Fibromyalgia and Chronic Fatigue Syndrome Research、Pain Mechanisms and Treatments

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 dissat...