ArticleJournal of general internal medicine2012
How much time do low-income patients and primary care physicians actually spend discussing pain? A direct observation study.
Article in Journal of general internal medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Development of the Chronic Pain Coding System (CPCS) for Characterizing Patient-Clinician Discussions About Chronic Pain and Opioids.Pain medicine (Malden, Mass.) · 2016Trial
- Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain.BMC family practice · 2021Observational
- Patient and provider characteristics associated with communication about opioids: An observational study.Patient education and counseling · 2019Observational
- Patient-Clinician Communication About Pain: A Conceptual Model and Narrative Review.Pain medicine (Malden, Mass.) · 2018Review
- A mixed methods study of patient-provider communication about opioid analgesics.Patient education and counseling · 2015Article
- The effect of discussing pain on patient-physician communication in a low-income, black, primary care patient population.The journal of pain · 2013Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
backgroundWe know little about how much time low-income patients and physicians spend discussing pain during primary care visits.
objectiveTo measure the frequency and duration of pain-related discussions at a primary care clinic serving mostly low-income black patients; to investigate variables associated with these discussions.
designWe measured the frequency and duration of pain-related discussions using video-recorded primary care visits; we used multiple regression to evaluate associations between discussions and patient self-report variables.
participantsA total of 133 patients presenting to a primary care clinic for any reason; 17 family medicine residents. MAIN MEASURES: Independent variables were pain severity, health status, physical function, chief complaint, and whether the patient and physician had met previously. Dependent variables were presence of pain-related discussions and percent of total visit time spent discussing pain. KEY
resultsSixty-nine percent of visits included pain-related discussions with a mean duration of 5.9 min (34% of total visit time). Increasing pain severity [OR 1.69, 95% CI (1.18, 2.41)] and pain-related chief complaints [OR 4.10, 95% CI (1.39, 12.12)] were positively associated with the probability of discussing pain. When patients discussed pain, they spent 4.5% more [95% CI (0.60, 8.37)] total visit time discussing pain for every one-point increase in pain severity. Better physical function was negatively associated with the probability of discussing pain [OR 0.65, 95% CI (0.48, 0.86)], but positively associated with the percent of total visit time spent discussing pain [3% increase; 95% CI (0.32, 5.75)] for every one-point increase in physical function). Patients and physicians who had met previously spent 11% less [95% CI (-21.65, -0.55)] total visit time discussing pain. Pain severity was positively associated with time spent discussing pain only when patients and physicians had not met previously.
conclusionsPain-related discussions comprise a substantial proportion of time during primary care visits. Future research should evaluate the relationship between time spent discussing pain and the quality of primary care pain management.
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