Patient-Centered Outcomes Research
Secondary Topic: Research Methodology
Tertiary Topic: Manual medicine/body work (including chiropractic and massage)
Differing definitions of chronic pain: Comparison of patients, providers, and researchers
Lara G. Hilton, MPH; Margaret D. Whitley, MPH; Gery Ryan, PhD; Ian D Coulter, PhD, RAND Corporation, Santa Monica, CA, United States
Late Breaker: No
Patient perspectives on what constitutes chronic pain are less understood than clinician and research definitions. We explored the relationships between these three perspectives on chronic low back and neck pain in order to inform health policy. This study is nested within an NCCIH Center of Excellence for Research on CAM.
In this comparative analysis, a cross sectional sample of chiropractic chronic low back and cervical pain patients (N=2024) was surveyed and asked about their perspectives on chronic pain. Their chiropractors were surveyed simultaneously (N=125). These data are compared with standard research definitions that are the recommended guidelines for inclusion in chronic pain studies developed by the NIH Low Back Pain Task Force and chronicity criteria used for inclusion in research studies found in literature review.
Format: Presentation with first author presenting for 15 minutes (10 minutes of content, 5 minutes for questions).
Findings indicate that patient definitions are misaligned with research and clinician definitions; however, research and clinical definitions overlap somewhat. Clinical and research definitions emphasize duration, while patient definitions emphasize permanency of the condition, quality of life, and function.
Patient attitudes about pain are important as they impact care seeking behaviors and expectations for outcomes. Findings are key for future research on chronic pain within the context of patient-centered care that emphasizes the provision of care that is respectful of and responsive to individual patient preferences, needs, and values.