Learning from people with chronic pain: messages for primary care practitioners

Abstract

INTRODUCTION: A large number of people live with chronic, non-malignant pain, which impacts on their work, social activity and quality of life. For many people pain appears to be inadequately treated and controlled, in part due to a reluctance to take appropriate medication. The aim of this study was to learn more about people’s experience of pain in the context of long-term illness, in order to inform primary health care practice. METHODS: Twenty people previously identified from a survey about chronic illness care were interviewed about their pain-related experiences. Interviews were taped and transcribed and a thematic analysis was carried out to identify the key themes relating to practitioners’ support of people with chronic pain. FINDINGS: Three main themes, which were common to all authors’ analyses and are considered most relevant to practice, are presented and discussed. These themes were labelled ‘medication concerns’, which encompasses side-effects, reluctance to take pills and pain medication as a choice; ‘coping with pain’, including acceptance, pacing yourself and non-pharmaceutical pain relief; and ‘seeking help for pain’, which included negative and positive experiences and lack of care continuity. CONCLUSION: Pain limited how participants lived, yet many were reluctant to take pain relief as prescribed, if at all. They found other ways of coping, and accepted their pain. Messages for practitioners include the importance of asking people about their pain, listening and acknowledging the reality of pain and its effect on daily life and providing education, reassurance and support for taking pain medication. KEYWORDS: Chronic disease; medication adherence; pain; primary health care; quality of life