Doctor recommendations influence pain treatment preference

21 Nov 2020
The opioid epidemic in the US has presented a complicated moral dilemma to doctors when treating potential drug abusers.The opioid epidemic in the US has presented a complicated moral dilemma to doctors when treating potential drug abusers.

Chronic pain patients show high degrees of interest in nonpharmacological, behavioural interventions to their condition, a recent study has found. This interest is even greater among patients whose doctors recommended these treatments.

A total of 1,050 participants (mean age, 37.50±11.94 years; 52.38 percent female) with chronic pain participated in the study and were anonymously, cross-sectionally surveyed. The survey sought to determine the participants’ receipt of behavioural treatments and their physicians’ recommendations of such, their pain severity and disability, the pharmacological medications they take, and potential opioid misuse. All measures were self-reported.

Nearly a third of the participants said that they had not received any of the behavioural interventions indicated on the survey. Those who had received such treatments had undergone an average of 2.32±1.26 behavioural interventions. The large majority (83.19 percent) of participants were taking medication for their pain. Nearly two-thirds of the sample were at risk of opioid misuse.

In conjunction, 37.18 percent of the participants reported that they had not received doctor recommendations for any behavioural treatments. On the other hand, 85.05 percent noted that they instead had been recommended medications.

Despite lapses in recommendations, 89.05 percent of the participants said that they were very or somewhat interested in undergoing at least one behavioural treatment, while only 73.69 percent expressed such an interest in pharmacological interventions.

Chi-square analysis further underscored the importance of physician recommendations, showing that interest for behavioural interventions was higher among patients who had received such a recommendation than those who had not. The same effect was true for pharmacological treatments.

J Pain 2020;21:979-987