title: Utilization and patients' perceptions of the effectiveness of pain treatments in multiple sclerosis: A cross-sectional survey.
abstract: BACKGROUND
  Although chronic pain is common among persons with multiple sclerosis (MS), little is known about the utilization and patients' perception of the effectiveness of pain treatments in MS.
  
  
  OBJECTIVE
  The objectives were to: (1) identify specific treatments currently used for pain relief by adults with MS; (2) examine patients' perceptions of the effectiveness of each of these treatments; and (3) examine rates of health care utilization, specifically provider and emergency department visits, for pain.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  One hundred twenty-five community-dwelling participants with MS and pain completed a postal survey that measured demographics, MS disease, pain, pain treatments, perceived effectiveness of treatments, and health care utilization.
  
  
  RESULTS
  The majority (89.6%) of the sample reported use of a variety of and multiple pain treatments (range = 1-19, median = 9.0, mean = 9.0, SD = 4.2); few were rated as providing pain relief. Non-prescription pain relievers were the most commonly reported treatment. Physical treatment modalities were also common. The treatments that were reported by patients to provide the greatest pain relief, such as hypnosis, nerve blocks, and marijuana, were not those that were the most frequently used. Overall, 75% reported at least one visit to a provider for pain in the past six months; participants made, on average, 9.7 visits for pain during this same time period. Emergency department visits explicitly for pain were reported by 11% of respondents.
  
  
  CONCLUSIONS
  These findings suggest that pain is inadequately treated from the perspective of persons with MS and results in a high level of health care utilization.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA. Electronic address: ehde@uw.edu.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Ehde
authors.affiliation: Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Alschuler
authors.affiliation: Evidence Based Treatment Centers of Seattle, Seattle, WA, USA.
authors.forename: Travis L
authors.initials: TL
authors.lastname: Osborne
authors.affiliation: River Valley Psychological Services, Issaquah, WA, USA.
authors.forename: Marisol A
authors.initials: MA
authors.lastname: Hanley
authors.affiliation: Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jensen
authors.affiliation: Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: George H
authors.initials: GH
authors.lastname: Kraft
mesh_terms: D000328:Adult; D000698:Analgesia / Q000379:methods*; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D004636:Emergency Service, Hospital; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D010146:Pain; D059408:Pain Management / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care; D010465:Perception; D011795:Surveys and Questionnaires
keywords: Chronic pain; Health care delivery; Multiple sclerosis; Pain