Goals of Chronic Pain Management: Do Patients and Primary Care Physicians Agree and Does it Matter?

摘要: Objective Assess patient-physician agreement on management goals for chronic musculoskeletal pain and its associations with patient physician visit experiences. Materials methods Pre-visit post-visit questionnaires 87 primary care visits that involved patients taking opioids resident physicians. After each visit, physicians independently ranked 5 treatment from most to least important. Results In total, 48% of reducing intensity as their top priority, whereas 22% finding a diagnosis Physicians improving function the priority 41% patients, medication side effects important 26%. The greatest difference between rankings was intensity. regression analyses, neither overall (ie, physician's first or second included patient's priority) nor in versus ranking significantly associated patient-reported experience (β agreement, -0.08; 95% confidence interval [CI], -0.45 0.30; P=0.69; β intensity, -0.06; CI, -0.17 0.04; P=0.24) physician-reported difficulty 1.92; -2.70 6.55; P=0.41; 0.42; -0.87 1.71; P=0.53). Discussion Patients prioritize substantially different management, but there is no evidence predicts difficulty. Primary may have adapted new recommendations emphasize functional avoidance long-term opioid therapy, continue focus