07 Mar Cedars-Sinai Study Will Address How Doctors Communicate With Patients About Chronic Pain

MedicalResearch.com Interview with:
Michelle S. Keller, MPH, PhD Candidate
Health Policy and Management
Cedars-Sinai
Los Angeles CA 90048

MedicalResearch.com: What is the background for this new funding award?

Response: Research shows that treating and managing chronic pain is tough, and it can be hard for patients and their physicians to be on the same page. Chronic pain touches so many facets of people’s lives—relationships, mental health, sleep, work—that treating it in a 15-minute visit can lead to a lot of frustration and disappointment.

Our hope is that by arming patients and clinicians with evidence-based tools, we can help foster a better dialogue about what is ultimately important to patients, how to achieve fully functional lives while managing chronic pain. We’re testing two different types of communication tools: electronic health record alerts pointing physicians to guidelines when they write opioid prescriptions and patient portal-based tools that can help patients prepare for visits and become active, engaged partners in their care.

MedicalResearch.com: Would you give some insight into the impact of the opioid impact in the US?

Response: The opioid epidemic has touched millions of people in the United States. Overdose deaths related to opioids now outnumber deaths from heroin and cocaine combined. More than half of all Americans know someone who has taken a prescription painkiller that wasn’t prescribed to them, know someone with an addiction problem or know someone who has died as the result of an opioid overdose. It’s striking that many of these problems started out with legitimate, legal prescriptions.

For many years, the medical community thought that opioids could help people with chronic pain. What we now know is that opioids can be helpful for a small group of people, but the evidence shows that they are not very effective for most individuals with chronic pain. We have to help people find better alternatives.

MedicalResearch.com: How is this planned study different from other studies of the opioid epidemic?  

Response: Very few interventions include patients and other stakeholders in their study design. Chronic pain patients, clinicians and several organizations such as Consumer Reports and the American Chronic Pain Association helped us construct this study and will help us with the intervention. It’s critical to involve patients because it keeps us grounded in what actually is important to them. Many other researchers make assumptions about what patients care about.

MedicalResearch.com: What do you hope to achieve?

Response: We hope to figure out how we can best communicate the risks of opioids and the best alternatives to these medications for people in chronic pain. While reducing high-risk opioid use is one of the outcomes of our study, we also will be tracking health-related quality of life and how much pain interferes with patients’ lives. By tracking these important patient-centered outcomes, we hope to show that reducing high-risk opioid use doesn’t leave patients in worse shape. Our hope is to share these findings with other health systems to help them design better interventions for their patients.

MedicalResearch.com: How will the results be distributed? 

Response: In addition to writing several academic papers, we will work with our partners to distribute our study results to patient groups, physicians and health system leaders. Our goal is to make our study results easy for people to understand and interpret. Our partners, Consumer Reports and the American Chronic Pain Association, are experts in communication. We hope to leverage their skills and networks to get the word out about what works and what doesn’t.

MedicalResearch.com: Is there anything else you would like to add?

Response: This study will also give us the opportunity to learn more about how patients and their doctors make decisions about treating and managing pain. We’re hoping to use these important findings to design other interventions in the future that aren’t necessarily focused on opioids and are centered around treating chronic pain more effectively.

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Last Updated on March 8, 2017 by Marie Benz MD FAAD