Examining influential factors in providers’ chronic pain treatment decisions: a comparison of physicians and medical students

BMC Medical Education

Adam T. Hirsh¹  Charnelle A. Free¹  Stephanie K. Middleton¹  Samantha Meints¹  Nicole A. Hollingshead¹ 

[1] Department of Psychology, Indiana University – Purdue University Indianapolis, 402 N Blackford, Indianapolis 46202, IN, USA

关键词: Chronic pain;    Virtual human;    Pain management;    Decision-making;   

Others  :  1228675
DOI  :  10.1186/s12909-015-0441-z

 received in 2015-02-19, accepted in 2015-09-12,  发布年份 2015

【 摘 要 】

Background

Chronic pain treatment guidelines are unclear and conflicting, which 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 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.

Methods

Eighty-five participants (35 medical students, 50 physicians) made treatment decisions for 16 computer-simulated patients with chronic pain. Participants then selected from provided lists the information they used and the information they would have used (had it been available) to make their chronic pain treatment decisions for the patient vignettes.

Results

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 and alcohol to make treatment decisions; while a greater proportion of physicians reported using personal experience to inform their decisions.

Discussion

This study found providers use patients’ information and their own experiences and intuition to make chronic pain treatment decisions. Also, participants of different training levels report using different patient and personal factors to guide their treatment decisions.

Conclusions

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.

【 授权许可】

   
2015 Hollingshead et al.

【 图 表 】

Fig. 1.

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