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Chronic Pain In America: Roadblocks To Relief
Summary of Findings
Role of the Medical Profession
- Incidence of going to doctors for relief.
- Use of hospital services.
- Length of delay before seeking relief from doctors.
- Reasons for a delay.
- Frequency of changing doctors when seeking relief.
- Reasons for changing doctors.
- Doctor's reactions to patient requests for a specific medicine.
- Incidence of referrals to specific clinics/programs for treatment.
ALMOST 40% OF CHRONIC PAIN SUFFERERS ARE NOT CURRENTLY GOING TO A DOCTOR FOR RELIEF OF THEIR PAIN; HOWEVER, THE MORE SEVERE THEIR PAIN, THE MORE LIKELY IT IS BEING TREATED BY A DOCTOR - 72% VERSUS 51% OF MODERATE PAIN SUFFERERS.
"Have you ever gone to a doctor for treatment of your pain?" (Q.5a) "Are you currently going to a doctor for treatment of your pain?" (Q. 5b) "What is the specialty of the doctor who is currently treating your pain?" (Q. 5c)
Base: All chronic pain sufferers.
| ---Severity of Pain Now--- | |||||
|---|---|---|---|---|---|
| Total % | Moderate % | Severe % | Very Severe % | ||
| Ever gone to a doctor for treatment of your pain | 94 | 92 | 92 | 98 | |
| Currently going to a doctor for treatment of your pain | 61 | 51 | 62 | 72 | |
| Specialty of their doctor: | |||||
| Family Practice/Internal medicine | 51 | 57 | 46 | 49 | |
| Orthopedic surgeon | 15 | 13 | 15 | 17 | |
| Rheumatology | 10 | 8 | 13 | 10 | |
| Neurology | 8 | 5 | 7 | 10 | |
| Chiropractor | 5 | 8 | 7 | 1 | |
| Other | 10 | 9 | 11 | 11 | |
| Don't know | 1 | 0 | 1 | 2 | |
CHRONIC PAIN SUFFERERS, ESPECIALLY THOSE WITH SEVERE PAIN, HAVE HAD A SIGNIFICANT NUMBER OF PAST YEAR OCCURENCES THAT REQUIRED EMERGENCY ROOM VISITS, HOSPITALIZATION OR COUNSELING FOR RELIEF OF THEIR PAIN.
"In the past 12 months, how many times, if any, have you (action) for your pain?" (Q, 7)
Base: All chronic pain sufferers ever going to a doctor for relief of their pain.
| ---Severity of Pain Now--- | ||||
|---|---|---|---|---|
| Total % | Moderate % | Severe % | Very Severe % | |
| Gone to a physician for their pain | ||||
| In past 12 months | 80% | 76% | 77% | 87% |
| Mean number of times | 6.7 | 6.0 | 7.1 | 7.2 |
| Gone to an ER for their pain | ||||
| In past 12 months | 14% | 11% | 13% | 19% |
| Been hospitalized for their pain | ||||
| In past 12 months | 11% | 9% | 13% | 13% |
| Had psychological counseling/therapy for their pain | ||||
| In past 12 months | 15% | 8% | 14% | 22% |
40% OF CHRONIC PAIN SUFFERERS WHO EVER WENT TO A DOCTOR DID SO WITHIN ONE MONTH AFTER THEIR PAIN BEGAN; STILL, AT LEAST ONE FOURTH WAIT AT LEAST 6 MONTHS AFTER THEIR PAIN BEGINS BEFORE GOING TO A DOCTOR.
"Again thinking back to when your pain first started, about how long did you wait before going to a doctor for treatment?" (Q. 6a)
Base: All chronic pain sufferers ever going to a doctor for relief of their pain.
| ---Severity of Pain Now--- | ||||
|---|---|---|---|---|
| Total % | Moderate % | Severe % | Very Severe % | |
| Less than 3 months | 55 | 52 | 56 | 59 |
| Less than one month | 40 | 38 | 36 | 46 |
| 1 or 2 months | 15 | 13 | 20 | 13 |
| 3 to 5 months | 14 | 15 | 13 | 14 |
| 6 to 12 months | 9 | 10 | 12 | 6 |
| Over one year | 18 | 21 | 17 | 17 |
| Don't know | 3 | 3 | 2 | 3 |
CHRONIC PAIN SUFFERERS DELAY GOING TO A DOCTOR FOR RELIEF PRIMARILY BECAUSE THEY UNDER-ESTIMATE THE PROBLEM AND THINK THEY CAN SEE IT THROUGH.
"Why didn't you go to a doctor sooner?" (Q. 6b)
Base: All chronic pain sufferers waiting for more than 3 months before going to a doctor for relief of their pain.
| ---Severity of Pain Now--- | ||||
|---|---|---|---|---|
| Total % | Moderate % | Severe % | Very Severe % | |
| Hoped/thought pain would go away | 27 | 28 | 25 | 28 |
| Pain wasn't serious/bad enough | 12 | 17 | 7 | 10 |
| Tried self treatment | 14 | 14 | 14 | 13 |
| Cost considerations | 11 | 8 | 16 | 13 |
| Thought it was something else | 10 | 9 | 16 | 8 |
| Too busy, time consuming | 9 | 6 | 8 | 12 |
| Have high tolerance for pain | 7 | 8 | 7 | 7 |
ALMOST ONE HALF OF ALL CHRONIC PAIN SUFFERERS WHO HAVE EVER GONE TO A DOCTOR FOR RELIEF OF THEIR PAIN, HAVE FOUND IT NECESSARY TO CHANGE DOCTORS IN THEIR SEARCH FOR RELIEF; ALMOST ONE FOURTH HAVE CHANGED DOCTORS AT LEAST 3 TIMES FOR THIS PURPOSE. THE MORE SEVERE THEIR PAIN, THE MORE LIKELY THEY HAVE CHANGED DOCTORS AND TO HAVE DONE SO MORE OFTEN.
"Since your pain first began, about how many times, if any, have you changed doctors to find relief of your pain?" (Q. 5d)
Base: All chronic pain sufferers ever going to a doctor for relief of their pain.
| ---Severity of Pain Now--- | ||||
|---|---|---|---|---|
| Total % | Moderate % | Severe % | Very Severe % | |
| Have changed doctors to find relief | 47 | 38 | 49 | 56 |
| Once | 11 | 10 | 9 | 12 |
| Twice | 13 | 11 | 16 | 13 |
| 3 times and more | 22 | 15 | 24 | 29 |
| Don't know | 1 | 2 | 0 | 2 |
THE PRIMARY REASONS FOR CHANGING DOCTORS RELATE FOR THE MOST PART TO HOW CHRONIC PAIN SUFFERERS PERCEIVE THE DOCTOR'S ATTITUDE TOWARD THEIR PAIN AND THE DOCTOR'S KNOWLEDGE ABOUT PAIN AND ABILITY TO TREAT PAIN.
"What were your reasons for changing doctors?" (Q. 5e)
Base: All chronic pain sufferers changing doctors to find relief for their pain.
| ---Severity of Pain Now--- | ||||
|---|---|---|---|---|
| Total % | Moderate % | Severe % | Very Severe % | |
| Still had too much pain | 42 | 33 | 45 | 48 |
| Didn't feel doctor knew a lot about pain treatment | 31 | 24 | 37 | 32 |
| Doctor didn't take pain seriously enough | 29 | 25 | 29 | 32 |
| Unwilling to treat pain aggressively | 27 | 23 | 28 | 29 |
| Doctor didn't listen | 22 | 18 | 23 | 25 |
| Too far to travel | 16 | 17 | 14 | 16 |
| Sufferer moved away | 14 | 12 | 16 | 14 |
| HMO/Insurance plan required it | 14 | 13 | 8 | 16 |
| Doctor made a referral/2nd opinion, needed specialist | 14 | 13 | 9 | 17 |
| Doctor retired from active practice, died, moved away | 16 | 16 | 18 | 14 |
CHRONIC PAIN SUFFERERS WHO HAVE NEVER GONE TO A DOCTOR FOR PAIN RELIEF OR ARE NOT CURRENTLY GOING TO ONE BELIEVE EITHER THERE IS NOTHING DOCTORS CAN DO TO HELP, THE PAIN IS UNDER CONTROL OR THAT THEY THEMSELVES CAN EITHER TREAT IT OR JUST LIVE WITH IT. COST IS A SIGNIFICANT BARRIER AMONG THOSE WITH SEVERE OR VERY SEVERE PAIN.
"What are your reasons for no longer/never going to a doctor for relief of your pain?" (Q. 8)
Base: All chronic pain sufferers never or not currently going to a doctor to find relief for their pain.
| ---Severity of Pain Now--- | ||||
|---|---|---|---|---|
| Total % | Moderate % | Severe % | Very Severe % | |
| Nothing they can do/no help | 24 | 21 | 24 | 29 |
| Treatment helped, taking medicine | 15 | 17 | 13 | 12 |
| Pain lessened, controlled, went away | 14 | 17 | 13 | 9 |
| Use OTC/self treatment | 14 | 17 | 10 | 11 |
| Cost, inadequate/no insurance | 14 | 9 | 21 | 18 |
| Unfavorable reaction to doctor/treatment | 12 | 9 | 8 | 15 |
| Learned to cope, live with it | 11 | 10 | 16 | 11 |
22% OF CHRONIC PAIN SUFFERERS HAVE ASKED THEIR DOCTOR FOR A MEDICINE THEY SAW OR HEARD ABOUT TO RELIEVE THEIR PAIN AND IN THE MAJORITY OF INSTANCES DOCTORS PRESCRIBE THE MEDICINE; ONLY 5% OF ALL SUFFERERS HAVE ASKED FOR SUCH A MEDICINE AND THEIR DOCTOR REFUSED TO PRESCRIBE IT.
"Have you ever asked a doctor for a specific medicine you saw or heard about?" (Q. 15a) "Did the doctor prescribe it or did he/she refuse to prescribe it for your pain?" (Q. 15b)
Base: All chronic pain sufferers.
| ---Severity of Pain Now--- | ||||
|---|---|---|---|---|
| Total % | Moderate % | Severe % | Very Severe % | |
| Asked doctor for a medicine seen/heard about | 22 | 16 | 24 | 29 |
| Prescribed it | 15 | 11 | 18 | 18 |
| Refused to prescribe it | 5 | 4 | 4 | 8 |
| Never asked | 77 | 82 | 76 | 71 |
22% OF CHRONIC PAIN SUFFERERS HAVE BEEN REFERRED TO A SPECIALIZED TREATMENT PROGRAM FOR THEIR PAIN; ONLY 3% OF ALL CHRONIC PAIN SUFFERERS WERE DENIED ACCESS BY A MANAGED CARE GATEKEEPER OR WORKMAN'S COMP PROGRAM AFTER SUCH A REFERRAL.
"Have you ever been referred to a specialized program or clinic for your pain that offered a team of health care professionals specializing in different areas of pain management?" (Q. 16a) "Were you ever denied access to all or part of this specialized treatment program by a managed care gatekeeper or workman's comp program?" (Q. 16b)
Base:0 All chronic pain sufferers.
| ---Severity of Pain Now--- | ||||
|---|---|---|---|---|
| Total % | Moderate % | Severe % | Very Severe % | |
| Referred to program/clinic | 22 | 16 | 19 | 32 |
| Denied access all/part | 3 | 2 | 1 | 5 |
| Never referred | 78 | 84 | 81 | 68 |
On to: Perceptions and Use of Medicine Types
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