title: Referring patients with chronic noncancer pain to pain clinics: survey of Ontario family physicians.
abstract: OBJECTIVE
  To examine the factors associated with FPs' referrals of patients with chronic noncancer pain to a tertiary care pain clinic.
  
  
  METHODS
  A questionnaire-based survey; data were analyzed using univariate methods.
  
  
  METHODS
  A tertiary care pain clinic in Toronto, Ont. Participants All FPs who referred patients to the clinic between 2002 and 2005.
  
  
  METHODS
  Variables explored included FPs' sex, age, and ethnic background, ethnicity of patient groups seen, and FPs' rationale or barriers influencing referrals to specialized pain clinics.
  
  
  RESULTS
  The response rate was 32% (47 of 148 FPs). There were no statistically significant differences between respondents and non-respondents in sex, age, duration of practice, and university of graduation, or between the variables of interest and the referral patterns of those who did respond. The mean age of respondents was 50 years; 47% of the FPs identified themselves as Canadian; and one-third of the respondents indicated that they referred more than 30 patients to pain clinics each year. The 3 most frequently cited reasons prompting referral to pain clinics were requests for nerve blocks or other injections, desire for the expertise of the program, and concerns about opioids; the 3 most prevalent barriers were long waiting lists, patient preference for other treatments, and distance from the clinic.
  
  
  CONCLUSIONS
  Although the results of our survey of FPs identify certain barriers to and reasons for referring patients to pain clinics, the results cannot be generalized owing to the small sample of FPs in our study. Larger studies of randomly selected FPs, who might or might not refer patients to pain clinics, are needed to provide a better understanding of chronic noncancer pain management needs at the primary care level.
authors.affiliation: Toronto Western Hospital, Toronto, ON M5T 2S8, Canada.
authors.forename: S Fatima
authors.initials: SF
authors.lastname: Lakha
authors.forename: Balaji
authors.initials: B
authors.lastname: Yegneswaran
authors.forename: Julio C
authors.initials: JC
authors.lastname: Furlan
authors.forename: Veronica
authors.initials: V
authors.lastname: Legnini
authors.forename: Keith
authors.initials: K
authors.lastname: Nicholson
authors.forename: Angela
authors.initials: A
authors.lastname: Mailis-Gagnon
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects; D002908:Chronic Disease; D003625:Data Collection; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D009407:Nerve Block; D009864:Ontario; D018710:Pain Clinics / Q000706:statistics & numerical data*; D059408:Pain Management; D057240:Patient Preference; D010821:Physicians, Family / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014850:Waiting Lists
chemical_list: D000701:Analgesics, Opioid