Chronic pain treatment guidelines are “unclear and conflicting,” according to authors of a new research published in BMC Medical Education.
The study looked at 35 medical students and 50 physicians, and their treatment decisions for 16 computer-simulated patients with chronic pain. The purpose of this study was to examine factors that reportedly influence providers’ chronic pain treatment decisions. A secondary aim was to examine differences across participant training level.
Frequency analyses indicated that most participants reported using patients’ pain histories (97.6 %) and pain description (95.3 %) when making treatment decisions, and they would have used information about patients’ previous treatments (97.6 %) and average and current pain ratings (96.5 %) had this information been available. Compared to physicians, medical students endorsed more frequently that they would have used patients’ employment and/or disability status (p < 0.05).
A greater proportion of medical students wanted information on patients’ use of illicit drugs, alcohol and employment / disability status to make treatment decisions, while a greater proportion of physicians reported using personal experience to inform their decisions.
“These results highlight the complexity of chronic pain care and suggest a need for more chronic pain education aimed at medical students and practicing providers,” the authors reported.
They found that the conflicting treatment guidelines contributes to inconsistent pain care.
“In order to improve pain care, it is important to understand the various factors that providers rely on to make treatment decisions,” the authors stated.
This was one of the first investigations to examine the factors that medical students and physicians report using to make chronic pain treatment decisions.
This study highlights the complexity of chronic pain management and suggests a need for medical and continuing education efforts to more strongly focus on systematic, evidence-based clinical decision-making in this context.
The study, Examining influential factors in providers’ chronic pain treatment decisions: a comparison of physicians and medical students, was authored by Nicole A. Hollingshead, Samantha Meints, Stephanie K. Middleton, Charnelle A. Free and Adam T. Hirsh.