Abstract
Impatient Patients: Navigating Chronic Pain Management during an Opioid Epidemic
Jennifer Hall, MPH1, Lindsey Alley, MS2, Sarah Haverly, MS2, Daniel Hartung, PharmD, MPH3, Nicole O'Kane, PharmD2, Jody Carson, RN, MSW, CPHQ2 and David Cameron, BA1
(1)Oregon Health and Science University, Portland, OR, (2)HealthInsight Oregon, Portland, OR, (3)Oregon State University / Oregon Health & Science University, Portland, OR
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Purpose: Chronic pain is a condition that impacts every aspect of patients’ lives, yet it is near impossible to objectively measure and difficult to treat. Over the past decade, prescription opioids have become the most widely employed mechanism for treating chronic pain; leading, in part, to the current opioid epidemic in America. Studies indicate that both the experience of being a chronic pain patient and a patient on prescription opioids carry unique forms of stigma; however, little is understood about how and from whom opioid-treated chronic pain patients perceive judgment for their diagnoses, or the mechanisms they employ to address it. The current study uses focus group data to better understand the stigma experience and its impacts within this unique patient population.
Methods: Three focus groups were held April through July of 2016 (N=18; Mage=60.1, range=30–77; 71% female). Participants were recruited via fliers and direct in-person engagement. Discussion focused on opioid-related communication between the patients and their pharmacists and prescribers, as well as barriers and benefits to receiving opioid treatment. Data were entered into NVivo and an immersion-crystallization approach was used to analyze the data.
Results/Outcomes: Opioid-treated chronic pain patients feel they are receiving judgment from people both inside and outside of healthcare settings. Patients report being labelled as ‘pain medicine seekers,’ ‘doctor shoppers,’ and ‘impatient patients’ because of actions taken by their practitioners that adversely impacted them. They also feel age and gender play a role in the extent to which their pain is legitimized. To counter perceived stigma-related barriers to care, patients employ advocates to attend appointments with them, restrict themselves to a single prescriber, and keep thorough medication records to resolve discrepancies in prescription reports when they visit pharmacies. Enhanced communication and pain trainings for pharmacists and prescribers may help address and prevent these stigma-related issues.
Planning of health education strategies, interventions, and programs Provision of health care to the public Social and behavioral sciences