title: Physician-to-physician telephone consultations for chronic pain patients: A pragmatic randomized trial.
abstract: BACKGROUND
  The impact of telephone consultations between pain specialists and primary care physicians regarding the care of patients with chronic pain is unknown.
  
  
  OBJECTIVE
  To evaluate the impact of telephone consultations between pain specialists and primary care physicians regarding the care of patients with chronic pain.
  
  
  METHODS
  Patients referred to an interdisciplinary chronic pain service were randomly assigned to either receive usual care by the primary care physician, or to have their case discussed in a telephone consultation between a pain specialist and the referring primary care physician. Patients completed a numerical rating scale for pain, the Pain Disability Index and the Short Form-36 on referral, as well as three and six months later. Primary care physicians completed a brief survey to assess their impressions of the telephone consultation.
  
  
  RESULTS
  Eighty patients were randomly assigned to either the usual care group or the standard telephone consultation group, and 67 completed the study protocol. Patients were comparable on baseline pain and demographic characteristics. No differences were found between the groups at six months after referral in regard to pain, disability or quality of life measures. Eighty percent of primary care physicians indicated that they learned new patient care strategies from the telephone consultation, and 97% reported that the consultation answered their questions and helped in the care of their patient.
  
  
  CONCLUSIONS
  Most primary care physicians reported that a telephone consultation with a pain specialist answered their questions, improved their patients' care and resulted in new learning. Differences in patient status compared with a usual care control group were not detectable at six-month follow-up.
  
  
  CONCLUSIONS
  While telephone consultations are clearly an acceptable strategy for knowledge translation, additional strategies may be required to actually impact patient outcomes.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Clark
authors.forename: Paul
authors.initials: P
authors.lastname: Taenzer
authors.forename: Neil
authors.initials: N
authors.lastname: Drummond
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Spanswick
authors.forename: Lori S
authors.initials: LS
authors.lastname: Montgomery
authors.forename: Ted
authors.initials: T
authors.lastname: Findlay
authors.forename: John X
authors.initials: JX
authors.lastname: Pereira
authors.forename: Tyler
authors.initials: T
authors.lastname: Williamson
authors.forename: Luz
authors.initials: L
authors.lastname: Palacios-Derflingher
authors.forename: Ted
authors.initials: T
authors.lastname: Braun
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000451:nursing* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D058007:Physicians, Primary Care; D011788:Quality of Life; D012017:Referral and Consultation; D013689:Telephone; D016896:Treatment Outcome