Transcript Patient Perspectives on Pain Medications

Patient Perspectives on
Pain Medications
•Deborah K. Nelson, M.A.
Patient Perspectives on
Pain Medications
Deborah K. Nelson, Psy.D.
Disclosures
• Deborah Nelson has disclosed no financial
relationships that may pose a conflict of
interest.
• There will be no unannounced disclosures of
off-label use of drugs, biologics or medical
devices.
Background
• Dissertation on older adults and their
perceptions of pain medications.
• Objective was to understand the reasons for
taking or not taking their pain medications.
• Strategy was in-home, semi-structured
interviews.
• Analyzed for themes and used to produce
DVD.
Major Findings
• Pain management, from the patient’s
perspective, is complex and idiosyncratic.
• Key to understanding each patient’s process is
to understand their individual goals and values.
• Just as the pain interfered with each subject’s
life goals, so too did the pain medications.
Scenario
• Many visit doctor with pain complaints.
• Doctors appointments are short.
• Patients are often quickly prescribed pain
medication.
• Even patients who are happy with their
physician are frustrated by this experience.
Ambivalence Towards the
Pain Medications
• Patient returns home with a prescription for
pain medication, but is ambivalent about
taking it.
• Ambivalence is driven by:
• Fear of addiction
• Fear of side effects
• Too many pills
Fear of Addiction
• Most frequently mentioned among the study’s
participants -- regardless of family or personal
history of addiction.
Fear of Side Effects
• Most common side effects mentioned:
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dopiness
dizziness / unsteadiness on feet
dryness
headaches and stomach troubles
• Salience of side effect(s) varied from
individual to individual and was tied to goals
for the day (e.g. resting versus driving a car).
Too Many Pills
• Everyone in this study was taking other
medication for a variety of health issues.
• Medication burden concerns primarily related to:
• the physical requirement to consume so many pills
• concerns about a variety of drugs in their body
Tough Choices
• Patients ask themselves the following
questions:
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How long will the pain last?
How severe will it get?
What activities do I need / want to do?
If I take the pain medication, how much will the
pain be reduced and for how long?
• What will the side effects be and can I manage
them?
Other Research Findings
• After taking the pain medication, many
patients felt frustration and anger.
• Socioeconomic differences.
Concluding Remarks
• Pain management is complex and idiosyncratic – for
both the patient and the physician.
• Key to understanding each patient’s process is to
understand their individual goals and values.
• Fears and lack of knowledge result in ambivalence.
• Patients want more assistance / support in making
pain management and medication decisions.
• Patients want a more cautious and thorough
approach to pain management.
Thank You
Deborah K. Nelson, Psy.D.
PSY 27324
[email protected]
© Deborah K. Nelson, Psy.D.