Chronic Non-Cancer Pain: A Siren for Primary Care – A Report From the PRImary care MultiEthnic Network (PRIME Net)
Journal of the American Board of Family Medicine, 10/25/2011

Leverence RR et al. – Guidelines and increased continuing medical education alone are unlikely to be the solutions to the challenges of chronic non–cancer pain (CNCP) management. Increased evidence for recommendations and resources for more comprehensive care management are needed.

• Authors conducted a survey in the Primary Care MultiEthnic Network, a consortium of PBRNs of primary care clinicians practicing in low–income, medically underserved communities, and in a network of private primary care offices.
• Of 792 clinicians surveyed, 497 (63%) participated.

• Responses and accompanying narrative comments clustered around 5 themes:
• barriers to and uncertainties in optimal management
• the complex biopsychosocial nature of CNCP
• seriousness of prescription opioid abuse
• effort and burden required to properly manage CNCP
• clinician commitment to provide care for CNCP patients and benefits of expanded care model for CNCP
• One–third reported a severe outcome (death or life–threatening event) in a CNCP patient for whom they had prescribed opioids.
• Roughly one–third do not initiate prescribing of opioids