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Investigating the barriers to effective management of musculoskeletal pain: an international survey

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Abstract

An international study was performed to investigate the discrepancy between physician and population perception of the management of musculoskeletal pain (MP). One thousand, one hundred and fifty-four people with MP and 604 primary care physicians randomly selected from six countries (UK, Germany, Italy, France, Australia and Mexico) were interviewed by telephone. The interviews were based on structured questionnaires that captured: the management of pain, knowledge about the condition, sources of information, information communicated within the consultation, and patient roles in pain management. People with MP are confused about the different treatment options available (up to 63% out of N = 1,154) to them and their relative benefits and risks (33–51%). Doctors are the most valued and appropriate source of information (by up to 80% of people, N = 1,154) but are difficult to access. When people do have a clinical consultation, there may be a disparity between the information doctors convey and patient recall of the information provided. For example, most doctors tell patients the number of tablets they will need to take to achieve optimal pain relief, but only 34–63% of people with MP recall being given this information. Lack of information may partially explain why so few people (7–36%) return to their doctor when their prescribed medication is ineffective. This survey identified lack of information as a potential barrier to effective treatment. Physicians’ perceptions that people with MP are not able to appraise all the information and may prefer a passive role in their care need to be challenged if patients are to be participants in the management of their condition.

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Funding

Arthritis Action Group (AAG) is an independent group of specialist physicians and academics, developed with support from Pfizer in 2001. AAG acknowledges that this survey was conducted with support from Pfizer. AAG retains complete control over study design, data analysis and communication of results.

Authors and contributors

AD Woolf was involved in the design of the study, interpretation of the results, drafting and revising the paper and approving the final version for publication. J Frohlich, M Guslandi, B Michel and H Zeidler were involved in the interpretation of the results, revising the paper and approving the final version for publication. AJ Carr was involved in the design of the study, analysis of the data, interpretation of the results, drafting and revising the paper and approving the final version for publication. The other members of the Arthritis Action Group: Dr. A Aly, Dr. N Amin, Professor P Bertin, Dr. Bolten, Professor Chaussade, Professor Cucinotta, Professor Haglund, Dr. Martin Mola, Dr. Rahmen and Dr. Veale were actively involved in the review and interpretation of the data and approved the final version of the paper for publication.

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None.

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Authors and Affiliations

  1. Rheumatology, Royal Cornwall Hospitals Trust, Treliske, Truro, Cornwall, TR1 3LJ, UK

    Anthony Woolf

  2. Musculoskeletal Epidemiology, Academic Rheumatology, University of Nottingham, Nottingham, UK

    Alison Carr

  3. Department of Clinical Pharmacology, Hannover Medical School, Hannover, Germany

    Jurgen Frolich

  4. Gastroenterology, School of Medicine, S. Raffaele University, Milan, Italy

    Mario Guslandi

  5. Clinical Hepato-Gastroenterology Unit, S. Raffaele University Hospital, Milan, Italy

    Mario Guslandi

  6. Rheumatology, Institute of Physical Medicine, University Hospital Zurich, Zurich, Switzerland

    Beat Michel

  7. Medicine and Rheumatology, Medizinische Hochschule, Hannover, Germany

    Henning Zeidler

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  1. Anthony Woolf
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  2. Alison Carr
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  3. Jurgen Frolich
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  4. Mario Guslandi
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  5. Beat Michel
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  6. Henning Zeidler
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on behalf of the Arthritis Action Group

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Correspondence to Anthony Woolf.

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Woolf, A., Carr, A., Frolich, J. et al. Investigating the barriers to effective management of musculoskeletal pain: an international survey. Clin Rheumatol 27, 1535–1542 (2008). https://doi.org/10.1007/s10067-008-0965-2

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  • DOI: https://doi.org/10.1007/s10067-008-0965-2

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