Physicians & patients may not see eye-to-eye on pain management goals — but does it matter?

Physicians and patients tend not to have the same priorities when it comes to managing postoperative pain, according to a study published in The Clinical Journal of Pain.

Researchers examined 87 patients receiving opioid prescriptions for chronic musculoskeletal pain and 49 internal or family medicine physicians at two UC Davis Medical Center clinics in Sacramento, Calif. Patients filled in questionnaires related to their pain management priorities, while physicians completed questionnaires focusing on their own rankings for pain management goals.

Here are five insights:

1. Forty-eight percent of patients ranked reducing pain intensity as their top priority, followed by 22 percent who ranked diagnosing the pain source as most important.

2. Most physicians (41 percent) ranked improving function as their top pain priority for patients, while 26 percent ranked reducing side effects of medications as most important.

3. Additionally, in 62 percent of visits, a physician's top-ranked treatment priorities did not include the patient's first-ranked treatment priority.

4. For physicians, 41 percent of the patient visits were "challenging or emotionally taxing."

5. However, most patients ranked their visits as positive, even when the physician did not.

"This may reflect the fact that patients tend to have positive relationships with their regular physicians, even though they don't always agree with them," noted lead study author Stephen Henry, MD, an assistant professor of internal medicine at UC Davis.

Researchers now want to develop best practices for patient-physician communications to help align pain management goals.

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