title: Chronic non-cancer pain: a siren for primary care--a report from the PRImary Care MultiEthnic Network (PRIME Net).
abstract: BACKGROUND
  Patients with chronic non-cancer pain (CNCP) are common and have a high degree of morbidity. Previous studies document clinician frustration and variability in CNCP management. We conducted this study to gather in-depth clinicians' views about factors that affect management of CNCP.
  
  
  METHODS
  We conducted a survey in the Primary Care MultiEthnic Network, a consortium of PBRNs of primary care clinicians practicing in low-income, medically underserved communities, and in a network of private primary care offices.
  
  
  RESULTS
  Of 792 clinicians surveyed, 497 (63%) participated. Responses and accompanying narrative comments clustered around 5 themes: (1) barriers to and uncertainties in optimal management; (2) the complex biopsychosocial nature of CNCP; (3) seriousness of prescription opioid abuse; (4) effort and burden required to properly manage CNCP; and (5) clinician commitment to provide care for CNCP patients and benefits of expanded care model for CNCP. One-third reported a severe outcome (death or life-threatening event) in a CNCP patient for whom they had prescribed opioids. Roughly one-third do not initiate prescribing of opioids.
  
  
  CONCLUSIONS
  Guidelines and increased continuing medical education alone are unlikely to be the solutions to the challenges of CNCP management. Increased evidence for recommendations and resources for more comprehensive care management are needed.
authors: PRIME Net Consortium, Department of Medicine, University of New Mexico, Albuquerque 87131, USA.
authors: Robert R
authors: RR
authors: Leverence
authors: Robert L
authors: RL
authors: Williams
authors: Michael
authors: M
authors: Potter
authors: Douglas
authors: D
authors: Fernald
authors: Mark
authors: M
authors: Unverzagt
authors: Wilson
authors: W
authors: Pace
authors: Bennett
authors: B
authors: Parnes
authors: Elvan
authors: E
authors: Daniels
authors: Betty
authors: B
authors: Skipper
authors: Robert J
authors: RJ
authors: Volk
authors: Anthony E
authors: AE
authors: Brown
authors: Robert L
authors: RL
authors: Rhyne
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D003153:Community Health Services / Q000458:organization & administration; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006302:Health Services Research / Q000458:organization & administration; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid