Conflict Between Patient, Provider in Managing the Chronic Pain and OUD

In rural settings, patients and providers are frequently reading from different scripts when it comes to managing these conditions

Patient-centered chronic pain and opioid use disorder (OUD) management may be more beneficial to patients, but executing this individualized approach requires time, resources, and communication strategies—some of which can be a challenge due to limited health care resources.

In a poster presented at the APhA 2022 Annual Meeting and Exposition, researchers from the University of Wisconsin-Madison School of Pharmacy set out to identify the patient and provider challenges within the patient-centered care model for OUD and chronic pain in a rural community in Wisconsin.

Primary findings included numerous similarities and discrepancies between patient and provider perceptions of management challenges across multiple dimensions. On the micro level, for example, provider perspective indicates limited patient knowledge in terms of opioid risk and patient resistance toward tapering. From the patient perspective, however, patients engage in maladaptive behavior in order to avoid being stigmatized. While both parties agreed that a lack of resources and inadequate insurance reimbursement for nonopioid interventions is a major pain management problem, disagreements were noted across other elements of pain management and OUD treatment. Overall, the researchers noted, the study findings suggest that “patients and providers in rural communities don’t ‘read from the same script’ most of the time regarding challenges related to managing chronic pain and OUD.”

Results indicate that within rural communities, efforts should be made to provide training and education to enhance provider capacity to manage patients with chronic pain and OUD, including medication assisted treatment. Efforts are also needed to “mitigate stigma among providers.”

Future research should evaluate “the impact of including recovery coaches in the OUD management team” on patient outcome and retention in therapy.

Reference

Qudah B, Maurer MA, Mott DA, Chui MA. Discordance in addressing opioid crisis in rural communities: patient and provider perspective. Presented at: American Pharmacists Association 2022 Annual Meeting & Exposition; March 18-21, 2022; San Antonio, TX