A qualitative study of the barriers to chronic pain management in the ED.
OBJECTIVE
This qualitative study sought to identify perceived barriers to diagnosing and treating patients with chronic pain in the emergency department (ED).


METHODS
Semistructured interviews were conducted with 24 ED physicians from 4 hospitals to elucidate their experiences of managing chronic pain in the ED.


RESULTS
Time limitations and a low triage priority were major barriers to caring for patients with chronic pain. But despite the inherent problems of treating a nonurgent condition in a time-limited setting, physicians were strong proponents for treating chronic pain in the ED.


CONCLUSIONS
Acknowledging that pain can neither be verified nor disproved, physicians tend to err on the side of the patient, often providing an allotment of opioid medications. They also believe that the ED is not an optimal setting for treating patients in chronic pain but that it is often the last resort for many of these patients, thus, providing the rationale for serving them to the best of their ability.
Wilsey
Barth L
BL
VA Northern California Health Care System, Sacramento, CA 95655, USA. blwilsey@ucdavis.edu
Fishman
Scott M
SM
Crandall
Margie
M
Casamalhuapa
Carlos
C
Bertakis
Klea D
KD
D000701:Analgesics, Opioid / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010146:Pain / Q000175:diagnosis* / Q000188:drug therapy*; D010147:Pain Measurement; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D036301:Qualitative Research; D013997:Time Factors
D000701:Analgesics, Opioid