title: Analgesic treatment for moderate-to-severe acute pain in the United States: patients' perspectives in the Physicians Partnering Against Pain (P3) survey.
abstract: OBJECTIVE
  To evaluate patients' perceptions of the adequacy of analgesia for moderate-to-severe acute pain and the influence of opioid-related side effects in outpatient pain management.
  
  
  METHODS
  The Physicians Partnering Against Pain (P3) survey of analgesic treatment for moderate-to-severe acute pain in the United States.
  
  
  METHODS
  Adults with moderate-to-severe acute pain at their first analgesic followup visit.
  
  
  METHODS
  Analgesic level was determined from the World Health Organization'spain ladder (0 = none; 1 = nonopioid; 2 = weak opioid; 3 = strong opioid). Pain intensity was derived from numeric rating scale (NRS) scores (0 = none [NRS = 0]; 1 = mild [NRS = 1-3]; 2 = moderate [NRS = 4-7]; 3 = severe [NRS = 8-10). Pain management index scores were calculated as the analgesic level minus the pain intensity. Opioid recipients responded to questions on the P3 survey regarding side effects and their management.
  
  
  RESULTS
  Of the 50,869 patients with complete data for analysis, 22,267 (44 percent) had received potentially inadequate analgesia, including 43, 46, and 52 percent of patients aged < 65, 65-74, and > or = 75 years, respectively. Of the 39,6 75 patients treated with an opioid, 10,925 (28 percent) experienced at least one gastrointestinal side effect (nausea, vomiting or constipation). Many of these patients stopped taking the medication (13 percent) or reduced their dose (16 percent) to manage gastrointestinal side effects.
  
  
  CONCLUSIONS
  In the P3 study, one of the largest outpatient surveys conducted in pain management, moderate-to-severe acute pain continued to be widely undertreated in outpatient settings in the United States, particularly among older patients. Opioids with improved tolerability profiles might help to alleviate this undertreatment of moderate-to-severe acute pain.
authors.affiliation: Ortho-McNeil Janssen Scientific Affairs, LLC, Raritan, New Jersey, USA.
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Moskovitz
authors.forename: Carmela J
authors.initials: CJ
authors.lastname: Benson
authors.forename: Aarti A
authors.initials: AA
authors.lastname: Patel
authors.forename: Wing
authors.initials: W
authors.lastname: Chow
authors.forename: Samir H
authors.initials: SH
authors.lastname: Mody
authors.forename: Bill H
authors.initials: BH
authors.lastname: McCarberg
authors.forename: Myoung S
authors.initials: MS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D018710:Pain Clinics; D010147:Pain Measurement; D010353:Patient Education as Topic; D018579:Patient Selection; D010361:Patients / Q000523:psychology*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D000700:Analgesics