Isaac Scientific Publishing

Modern Clinical Medicine Research

Survey of Physician Perspective towards Management of Pain for Chronic Conditions in the Emergency Department

Download PDF (225 KB) PP. 55 - 70 Pub. Date: October 11, 2017

DOI: 10.22606/mcmr.2017.13002

Author(s)

  • Daniel Sop*
    Deptment of General Internal Medicine
  • Wally Smith
    Deptment of General Internal Medicine
  • Abdulkhaliq Alsalman
    Deptment of General Internal Medicine
  • Jennifer Li Wong
    Deptment of General Internal Medicine
  • Ding-Yu Fei
    Deptment of Biomedical Engineering
  • Donna McClish
    Deptment of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA
  • Azhar Rafiq
    Deptment of Surgery
  • Patrick Coyne
    Department of Palliative care, Medical University of South Carolina, Charleston, SC 29425, USA
  • Shirley Johnson
    Deptment of General Internal Medicine
  • Thokozeni Lipato
    Deptment of General Internal Medicine

Abstract

Sickle cell disease (SCD) pain is often acute-on-chronic, likening it to other chronic acuteon-chronic pain conditions. Pain treatment of SCD was already reported as inadequate prior to the current opioid epidemic, but attitudes underlying treatment were understudied. Understanding these attitudes prior to the current epidemic would be revealing. Therefore in 1997, before the current opioid epidemic, we surveyed physicians’ attitudes toward pain management and treatment preferences for acute pain exacerbations in the Emergency Department in SCD versus those of chronic pancreatitis and chronic low back pain, two other acute-on-chronic pain diseases. Thirty-nine residency trainees were surveyed in a level one triage hospital. Resident estimates of the rate of opioid addiction in SCD were higher than estimates in both chronic pancreatitis and chronic low back pain. Most residents relied on their personal clinical experience rather than external sources of data or knowledge as the most important driver when they managed chronic pain. This survey research shows that, predating the current opioid epidemic, there was both a backdrop of opioidphobia and a bias against treating SCD pain compared to other chronic pain conditions among our sample. Repeating this survey research among current training physicians, along with surveys of other attitudes, would provide useful comparisons.

Keywords

Pain management, sickle cell disease, opioids, chronic pain, internal medicine physicians

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