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Lalonde L, Choinière M, Martin E, et al. Priority interventions to improve the management of chronic non-cancer pain in primary care: a participatory research of the ACCORD program. J Pain Res. 2015;8:203-15doi: 10.2147/JPR.S78177.
Lalonde, L., Choinière, M., Martin, E., Lévesque, L., Hudon, E., Bélanger, D., Perreault, S., Lacasse, A., & Laliberté, M. C. (2015). Priority interventions to improve the management of chronic non-cancer pain in primary care: a participatory research of the ACCORD program. Journal of pain research, 8203-15. https://doi.org/10.2147/JPR.S78177
Lalonde, Lyne, et al. "Priority interventions to improve the management of chronic non-cancer pain in primary care: a participatory research of the ACCORD program." Journal of pain research vol. 8 (2015): 203-15. doi: https://doi.org/10.2147/JPR.S78177
Lalonde L, Choinière M, Martin E, Lévesque L, Hudon E, Bélanger D, Perreault S, Lacasse A, Laliberté MC. Priority interventions to improve the management of chronic non-cancer pain in primary care: a participatory research of the ACCORD program. J Pain Res. 2015 Apr 30;8:203-15. doi: 10.2147/JPR.S78177. eCollection 2015. PMID: 25995648; PMCID: PMC4425332.
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J Pain Res. 2015 Apr 30;8:203-15. doi: 10.2147/JPR.S78177. eCollection 2015.

Priority interventions to improve the management of chronic non-cancer pain in primary care: a participatory research of the ACCORD program.

Journal of pain research

Lyne Lalonde, Manon Choinière, Elisabeth Martin, Lise Lévesque, Eveline Hudon, Danielle Bélanger, Sylvie Perreault, Anaïs Lacasse, Marie-Claude Laliberté

Affiliations

  1. Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada ; Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Laval, QC, Canada ; Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada ; Sanofi Aventis Endowment Chair in Ambulatory Pharmaceutical Care, Faculty of Pharmacy Université de Montréal and Centre de santé et de services sociaux de Laval, QC, Canada.
  2. Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada ; Department of Anesthesiology Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
  3. Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada.
  4. Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Laval, QC, Canada ; Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada ; Department of Family Medicine and Emergency, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
  5. Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Laval, QC, Canada.
  6. Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada ; Sanofi Aventis Endowment Chair in Drug Utilization, Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada.
  7. Département des sciences de la santé, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada.
  8. Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada ; AbbVie Corporation, St-Laurent, QC, Canada.

PMID: 25995648 PMCID: PMC4425332 DOI: 10.2147/JPR.S78177

Abstract

PURPOSE: There is evidence that the management of chronic non-cancer pain (CNCP) in primary care is far from being optimal. A 1-day workshop was held to explore the perceptions of key actors regarding the challenges and priority interventions to improve CNCP management in primary care.

METHODS: Using the Chronic Care Model as a conceptual framework, physicians (n=6), pharmacists (n=6), nurses (n=6), physiotherapists (n=6), psychologists (n=6), pain specialists (n=6), patients (n=3), family members (n=3), decision makers and managers (n=4), and pain researchers (n=7) took part in seven focus groups and five nominal groups.

RESULTS: Challenges identified in focus group discussions were related to five dimensions: knowledge gap, "work in silos", lack of awareness that CNCP represents an important clinical problem, difficulties in access to health professionals and services, and patient empowerment needs. Based on the nominal group discussions, the following priority interventions were identified: interdisciplinary continuing education, interdisciplinary treatment approach, regional expert leadership, creation and definition of care paths, and patient education programs.

CONCLUSION: Barriers to optimal management of CNCP in primary care are numerous. Improving its management cannot be envisioned without considering multifaceted interventions targeting several dimensions of the Chronic Care Model and focusing on both clinicians and patients.

Keywords: chronic pain; community-based participatory research; health service accessibility; patient-centered care; primary health care

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