title: Patient's experience with comorbidity management in primary care: a qualitative study of comorbid pain and obesity.
abstract: OBJECTIVE
  The aim of this research is to examine perceptions of those with comorbid chronic pain and obesity regarding their experience of comorbidity management in primary care settings.
  
  
  BACKGROUND
  Chronic pain and obesity are common comorbidities frequently managed in primary care settings. Evidence suggests individuals with this comorbidity may be at risk for suboptimal clinical interactions; however, treatment experiences and preferences of those with comorbid chronic pain and obesity have received little attention.
  
  
  METHODS
  Semi-structured interviews conducted with 30 primary care patients with mean body mass index=36.8 and comorbid persistent pain. The constant comparative method was used to analyze data.
  
  
  RESULTS
  Participants discussed frustration with a perceived lack of information tailored to their needs and a desire for a personalized treatment experience. Participants found available medical approaches unsatisfying and sought a more holistic approach to management. Discussions also focused around the need for providers to initiate efforts at education and motivation enhancement and to show concern for and understanding of the unique difficulties associated with comorbidity. Findings suggest providers should engage in integrated communication regarding weight and pain, targeting this multimorbidity using methods aligned with priorities discussed by patients.
authors.affiliation: 1Department of Behavioral and Social Sciences,University of the Sciences,Philadelphia,PA,USA.
authors.forename: E Amy
authors.initials: EA
authors.lastname: Janke
authors.affiliation: 1Department of Behavioral and Social Sciences,University of the Sciences,Philadelphia,PA,USA.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Ramirez
authors.affiliation: 1Department of Behavioral and Social Sciences,University of the Sciences,Philadelphia,PA,USA.
authors.forename: Brittany
authors.initials: B
authors.lastname: Haltzman
authors.affiliation: 1Department of Behavioral and Social Sciences,University of the Sciences,Philadelphia,PA,USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Fritz
authors.affiliation: 2Department of Psychology,Oakland University,Rochester,NY,USA.
authors.forename: Andrea T
authors.initials: AT
authors.lastname: Kozak
mesh_terms: D059350:Chronic Pain / Q000453:epidemiology* / Q000628:therapy*; D015897:Comorbidity; D019468:Disease Management; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000628:therapy*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D036301:Qualitative Research
keywords: chronic pain; comorbidity; obesity