Assessing barriers to opioid pharmacotherapy for chronic pain in Montana
Sewell, Saundra Knowles.
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Chronic pain affects an estimated 76.2 million people in the United States yet health care providers face significant barriers to provision of safe and effective chronic pain management. Research has identified pharmacotherapy as an important component of a multi-disciplinary care plan for chronic pain management, but complexities associated with pain pharmacotherapy are also a source of barriers to chronic pain management. Little is known about barriers to provision of chronic pain management that may be unique to rural settings such as Montana. The primary goal of this research effort was to develop a questionnaire to assess barriers faced by health care providers to the use of pharmacotherapy for chronic pain in Montana. Following a comprehensive literature review of barriers to chronic pain management, a draft questionnaire containing 24 questions was developed and submitted to an expert panel of providers with prescriptive authority in Montana. A tailored Delphi technique was used to gather input about the proposed questionnaire from the expert panel. The results confirmed the importance of assessing barriers in Montana and the presence of significant barriers to opioid pharmacotherapy for chronic pain. The responses provided key information for revision of the questionnaire, improving the questionnaire clarity and relevance to Montana. This project represents an essential first step in the development of an assessment tool for use in Montana to identifying the existence and relative impact of barriers to chronic pain management. Understanding the relative influence and impact of these barriers will help mitigate barriers that impede adequate chronic pain management and help identify support needs of health care providers in chronic pain management.