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

Hollingshead NA, Meints S, Middleton SK, Free CA, Hirsh AT - BMC Med Educ (2015)

Bottom Line: 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.Also, participants of different training levels report using different patient and personal factors to guide their treatment decisions.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford, Indianapolis, IN, 46202, USA. nahollin@iupui.edu.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Training-level differences. *p < .05; ± refers to differences that were notable in magnitude but did not reach statistical significance. Each bar represents the percent of participants within each training level who endorsed using each factor in their chronic pain treatment decisions
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Fig1: Training-level differences. *p < .05; ± refers to differences that were notable in magnitude but did not reach statistical significance. Each bar represents the percent of participants within each training level who endorsed using each factor in their chronic pain treatment decisions

Mentions: Training level differences (medical student vs. physician) were examined in participants’ responses to the “Information used” and “Information would have used” questionnaires (notable differences displayed in Fig. 1).Fig. 1


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

Hollingshead NA, Meints S, Middleton SK, Free CA, Hirsh AT - BMC Med Educ (2015)

Training-level differences. *p < .05; ± refers to differences that were notable in magnitude but did not reach statistical significance. Each bar represents the percent of participants within each training level who endorsed using each factor in their chronic pain treatment decisions
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4591590&req=5

Fig1: Training-level differences. *p < .05; ± refers to differences that were notable in magnitude but did not reach statistical significance. Each bar represents the percent of participants within each training level who endorsed using each factor in their chronic pain treatment decisions
Mentions: Training level differences (medical student vs. physician) were examined in participants’ responses to the “Information used” and “Information would have used” questionnaires (notable differences displayed in Fig. 1).Fig. 1

Bottom Line: 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.Also, participants of different training levels report using different patient and personal factors to guide their treatment decisions.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford, Indianapolis, IN, 46202, USA. nahollin@iupui.edu.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus