Physician management of moderate-to-severe acute pain: results from the Physicians Partnering Against Pain (P³) study.
OBJECTIVE
To evaluate differences among physician specialties in the management of acute pain including prescribing practices and management of opioid-related side effects.


METHODS
The Physicians Partnering Against Pain (P³) survey was a nationwide study of US physicians and their patients with severe to moderate acute pain (<3 months).


METHODS
Physicians were surveyed about volume of patients with moderate-to-severe acute pain in their practice, frequency of prescribing opioid analgesics, percentage of these patients returning for a follow-up visit after treatment, reasons patients discontinue treatment, frequency of recommending or prescribing treatment for opioid-related gastrointestinal (GI) side effects, and frequency of patients taking opioid analgesics that take additional treatments to manage GI side effects.


RESULTS
The 5,982 participating physicians represented primary care physicians (PCPs; 52 percent), pain specialists (25 percent), and other specialists (23 percent). PCPs and other specialists were less likely than pain specialists to prescribe opioid analgesics to patients (25.8 percent, 29.5 percent, and 44.8 percent, respectively). The vast majority of pain specialists (78 percent) also indicated that more than three quarters of their patients returned for a follow-up visit compared with only 40 percent of PCPs and 65 percent of other specialists. When ranking the reasons why they think patients discontinue opioid analgesics, pain specialists ranked unacceptable side effects higher than PCPs and other specialists. PCPs and pain specialists were more likely than other specialists to recommend or prescribe treatments to manage opioid-related side effects, such as nausea, vomiting, and constipation (38.3 percent, 38.5 percent, and 23.1 percent, respectively).


CONCLUSIONS
The P(3) Study confirms the challenge of pain management while balancing tolerability of opioid treatments from the physician perspective.
Department of Family Medicine Neighborhood Healthcare, Escondido, California.
Bill H
BH
McCarberg
Health Economics and Outcomes Research, Janssen Scientific Affairs, Raritan, New Jersey.
Aarti A
AA
Patel
Health Economics and Outcomes Research, Janssen Scientific Affairs, Raritan, New Jersey.
Carmela J
CJ
Benson
Health Economics and Outcomes Research, Janssen Scientific Affairs, Raritan, New Jersey.
Samir H
SH
Mody
Health Economics and Outcomes Research, Janssen Scientific Affairs, Raritan, New Jersey.
Wing
W
Chow
Saint Vincent College, Alex G. McKenna School Department of Economics, Latrobe, Pennsylvania.
Carla L
CL
Zema
Medical Affairs, Janssen Scientific Affairs, Raritan, New Jersey.
Gary J
GJ
Vorsanger
Medical Affairs, Janssen Scientific Affairs, Raritan, New Jersey.
Myoung S
MS
Kim
D059787:Acute Pain / Q000175:diagnosis / Q000628:therapy*; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D055118:Medication Adherence; D018710:Pain Clinics; D059408:Pain Management / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
D000701:Analgesics, Opioid