title: Family medicine physicians' views of how to improve chronic pain management.
abstract: OBJECTIVE
  To determine family practice provider views of how to improve chronic nonmalignant pain (CNMP) management in primary care.
  
  
  METHODS
  Modified Delphi group process with providers randomly selected from 6 community practice sites: 3 federally qualified community health centers, 1 rural health center, and 2 hospital-owned practices. Providers gave structured written feedback in response to a report of provider and patient concerns about the quality of CNMP in their practice sites and participated in a facilitated discussion in 1 of 3 group meetings.
  
  
  RESULTS
  54% participation (n=14) of family physicians, 6 to 30 years out of residency, identified 4 major themes for improvement of CNMP treatment: (1) the need for provider practice guidelines; (2) changes in the monthly opioid prescription refill process; (3) provision of self-management support and access to alternative treatments for patients; and (4) the use of a nurse care manager.
  
  
  CONCLUSIONS
  Family physicians identified multiple components of practice that would improve both provider and patient experiences during and outcomes of CNMP management. Recommendations lend themselves to consideration of CNMP as a chronic illness and use of the Chronic Care Model as an appropriate framework for quality improvement.
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical School, Boston, USA. Linda.ClarkFHCW@umassmed.edu
authors.forename: Linda Garufi
authors.initials: LG
authors.lastname: Clark
authors.forename: Carole C
authors.initials: CC
authors.lastname: Upshur
mesh_terms: D002908:Chronic Disease; D003697:Delphi Technique; D005194:Family Practice; D006801:Humans; D020380:Needs Assessment; D059408:Pain Management; D010818:Practice Patterns, Physicians'