Management of chronic pain among older patients: Inside primary care in the US
Article first published online: 10 JAN 2012
2011 European Federation of Chapters of the International Association for the Study of Pain
European Journal of Pain
Volume 15, Issue 10, pages 1087.e1–1087.e8, November 2011
How to Cite
Tai-Seale, M., Bolin, J., Bao, X. and Street, R. (2011), Management of chronic pain among older patients: Inside primary care in the US. European Journal of Pain, 15: 1087.e1–1087.e8. doi: 10.1016/j.ejpain.2011.06.012
- Issue published online: 10 JAN 2012
- Article first published online: 10 JAN 2012
- Received 7 July, 2010; Revised 19 May, 2011; Accepted 23 June, 2011
- Chronic pain;
- Primary care;
Under-treatment of pain is a worldwide problem. We examine how often pain was addressed and the factors that influence how much time was spent on treating pain.
We analyzed 385 videotapes of routine office visits in several primary care practices in the Southwest and Midwest regions of the United States. We coded the visit contents and the time spent on pain and other topics. Logistic regression and survival analyses examined the effects of time constraint, physician's supportiveness, patient's health, and demographic concordance. We found that discussion of pain occurred in 48% of visits. A median of 2.3 min was spent on addressing pain. The level of pain, physician's supportiveness, and gender concordance were significantly associated with the odds of having a pain discussion. Time constraints and racial concordance significantly influenced the length of discussion.
We conclude that despite repeated calls for addressing under-treatment for pain, only a limited amount of time is used to address pain among elderly patients. This phenomenon could contribute to the under-treatment of pain.