Article Text
Abstract
Objectives To identify barriers to effective pain management encountered by patients with chronic pain within the UK’s National Health Service (NHS).
Design Secondary analysis of face-to-face, semistructured qualitative interviews using thematic analysis.
Setting A community-based chronic pain clinic jointly managed by a nurse and pharmacist located in the North of England.
Participants Nineteen adult (>18 years) patients with chronic pain discharged from a pain clinic, with the ability to understand and speak the English language.
Results In general, patients were highly disappointed with the quality of pain management services provided both within primary and secondary care, and consequently were willing to seek private medical care. Barriers to effective pain management were divided into two main themes: healthcare professional-related and health systems-related. Three subthemes emerged under healthcare professionals-related barriers, namely (1) healthcare professionals’ lack of interest and empathy, (2) general practitioners’ (GP) lack of specialised knowledge in pain management and (3) lack of communication between healthcare professionals. Three subthemes emerged under health system-related barriers: (1) long waiting time for appointments in secondary care, (2) short consultation times with GPs and (3) lack of an integrated multidisciplinary approach.
Conclusions The patients expressed a clear desire for the improved provision and quality of chronic pain management services within the NHS to overcome barriers identified in this study. An integrated holistic approach based on a biopsychosocial model is required to effectively manage pain and improve patient satisfaction. Future research should explore the feasibility, effectiveness and cost-effectiveness of integrated care delivery models for chronic pain management within primary care.
- Barriers
- Pain management
- Chronic pain
- Primary care
- General Practitioners
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Footnotes
Acknowledgements The authors would like to thank all the patients who participated in the study. The authors are also grateful to Linda Simpson, Clinical Pharmacist at the Boots Pharmacy, for her help in patient recruitment.
Contributors MAH conceived the idea. MAH and KM recruited patients. MAH analysed data under the supervision of MB, DPA and SJC. MAH prepared the first draft, which was revised with intellectual input by MB, DPA and SJC. All authors have read and approved the final version.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Yorkshire and the Humber – Leeds West NHS Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Additional supporting data are available upon request from the corresponding author.
Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.