Journal of General Internal Medicine

, Volume 35, Issue 1, pp 190–197 | Cite as

Satisfaction with Primary Care Providers and Health Care Services Among Patients with Chronic Pain: a Mixed-Methods Study

  • Inga GrußEmail author
  • Alison Firemark
  • Carmit K. McMullen
  • Meghan Mayhew
  • Lynn L. DeBar



Chronic pain is a prevalent health concern in the United States (US) and a frequent reason for patients to seek primary care. The challenges associated with developing effective pain management strategies can be perceived as a burden on the patient-provider relationship.


This study explored the relationship between patients’ overall satisfaction with their primary care providers (PCPs) and their satisfaction with their chronic pain treatment, as well as the provider behaviors that contributed to chronic pain patients’ satisfaction with their PCPs.


Concurrent nested mixed-methods design


97 patients with chronic pain who were assigned to the usual care arm of the Pain Program for Active Coping and Training (PPACT) study.


We analyzed phone interview and survey data (n = 97). Interviews assessed provider behaviors that led to patient satisfaction. Interview transcripts were analyzed based on a content analysis approach. Survey responses assessed patient satisfaction with primary care and pain services. We calculated a Pearson’s correlation coefficient using five response categories.

Key Results

Interviews revealed that high satisfaction with primary care was driven by five concrete PCP behaviors: (1) listening, (2) maintaining communication with patients, (3) acting as an access point to comprehensive pain care, (4) providing an honest assessment of the possibilities of pain care, and (5) taking time during consultations with patients. In surveys, participants reported higher satisfaction with their primary care services than with the pain services they received; these variables were only moderately correlated (r = 0.586).


Results suggest that patients with chronic pain can view the relationship with their PCPs as positive, even in the face of low satisfaction with their pain treatment. The expectations that these patients held of PCPs could be met regardless of providers’ ability to successfully relieve chronic pain.


primary care relationship chronic pain treatment satisfaction mixed methods 


Funding Information

The PPACT study is supported by the National Institutes of Health (NIH) Common Fund, through a cooperative agreement (UH2AT007788, UH3NS088731) from the Office of Strategic Coordination within the Office of the NIH Director.

Compliance with Ethical Standards

The study was approved by the KPNW Institutional Review Board. All study procedures followed the ethical standards of the responsible committee on human experimentation and the Helsinki Declaration of the World Medical Association.

Conflict of Interest

The authors declare that they do not have a conflict of interest.


The views presented here are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

Supplementary material

11606_2019_5339_MOESM1_ESM.docx (16 kb)
ESM 1 (DOCX 15 kb)


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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Inga Gruß
    • 1
    Email author
  • Alison Firemark
    • 1
  • Carmit K. McMullen
    • 1
  • Meghan Mayhew
    • 1
  • Lynn L. DeBar
    • 2
  1. 1.Kaiser Permanente Center for Health ResearchPortlandUSA
  2. 2.Kaiser Permanente Washington Health Research InstituteSeattleUSA

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