As part of our work with the National Science Foundation, we interviewed over 100 primary care and pain specialty providers to better understand their experiences and challenges they face when caring for chronic pain patients. Here are some of the insights we gained from those interviews:
- Lack of time and resources: Simply put, there is not enough time in the day to accomplish everything being asked of healthcare providers. This can make it particularly difficult to provide comprehensive pain management for patients with chronic pain who historically require longer and more frequent office visits, who submit a disproportionate number of electronic health messages compared to other patients, have more frequent phone calls to the office, and utilize urgent and emergency services more frequently. While the follow-up clinical encounter supports a status quo chronic pain assessment, it does not provide adequate time for new symptoms, flare ups, issues related to unstable chronic pain conditions or other factors requiring adjustments to more complex treatment plans. Additionally, many primary care providers lack easy access to pain management specialists or other treatment modalities for patients, such as physical, social, or mental health services that can help patients manage their pain effectively.
- Complex medical histories: Patients with chronic pain often have complex medical histories that may involve multiple comorbidities, which can make pain management more challenging. Providers must take into account the patient's entire medical history when managing their pain, which can be time-consuming and require specialized expertise. This can become quite complex given the patient's number of specialists and the patient's inability to accurately describe the nature and outcome of those visits.
- Patient adherence: Patients with chronic pain may struggle to adhere to pain management protocols, which can make it difficult to manage their pain effectively. This can be due to a range of factors, including fear avoidance, side effects of medications, or lack of access to non-pharmacologic pain management strategies.
- Patient expectations: Patients with chronic pain may have high expectations for pain relief, which can sometimes be difficult to meet. Finding the right balance between providing evidence-based care that meets regulatory requirements while still providing effective pain management has proven to be a challenge for most providers.
- Meeting regulatory requirements: Regulatory requirements associated with opioid prescribing are dynamic, leading to an increased need for provider education on how to meet medical board and CDC guidelines while also effectively managing the patient’s pain. Documentation burdens surrounding the patient’s reason for chronic opioid therapy, communications regarding risks, side effects, and opioid use disorder, demonstration of improved physical function as a result of opioid therapy, and adherence to routine drug screening and medication safety protocols can prove challenging and time consuming for most providers.
Overall, managing chronic pain requires a holistic approach that takes into account the patient's entire medical history, comorbidities, and risk factors, while balancing the need for effective pain management with the risks of opioid use disorder and other adverse effects associated with opioids. It also requires ongoing patient education and support to ensure that patients are able to adhere to pain management protocols and achieve the best possible outcomes.
OPOS delivers a controlled substance risk management platform that is combined with pain specialty services integrated into both primary care and pain specialty practices. OPOS solutions provide the resources to deliver more personalized chronic pain care, create new streams of revenue and increase practice capacity for new patients. OPOS overcomes the challenges of managing chronic pain patients and associated controlled substance prescribing to reduce provider burnout and improve patient outcomes.