The Patient–Provider Relationship in Chronic Pain Care: Providers' Perspectives

Matthias, Marianne S.; Parpart, Amy L.; Nyland, Kathryn A.; Huffman, Monica A.; Stubbs, Dawana L.; Sargent, Christy; Bair, Matthew J.

doi:10.1111/j.1526-4637.2010.00980.x

Cited by 298Patient-Provider Communication in HealthcareMusculoskeletal pain and rehabilitationPrimary Care and Health Outcomes

The Patient–Provider Relationship in Chronic Pain Care: Providers' Perspectives

Matthias, Marianne S., Parpart, Amy L., Nyland, Kathryn A., Huffman, Monica A., Stubbs, Dawana L., Sargent, Christy, Bair, Matthew J.·2010·Pain Medicine

DOI 10.1111/j.1526-4637.2010.00980.x

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Abstract

BACKGROUND: Pain is the most commonly reported symptom in primary care and is a leading cause of disability. Primary care providers (PCPs) face numerous challenges in caring for patients with chronic pain including communication and relational difficulties. OBJECTIVE: The objective of the study was to elicit providers' perspectives on their experiences in caring for patients with chronic pain. DESIGN: The design used was a qualitative study using open-ended, in-depth interviews. PARTICIPANTS: Twenty providers (10 men, 10 women) from five different clinics were interviewed at the Roudebush Veterans Affairs Medical Center. RESULTS: Three broad themes emerged from the analysis: 1) providers emphasized the importance of the patient-provider relationship, asserting that productive relationships with patients are essential for good pain care; 2) providers detailed difficulties they encounter when caring for patients with chronic pain, including feeling pressured to treat with opioids, believability of patients' reports of pain, worries about secondary gain/diversion, and "abusive" or "difficult" patients; and 3) providers described the emotional toll they sometimes felt with chronic pain care, including feeling frustrated, ungratified, and guilty. FINDINGS: Findings were interpreted within a model of patient-centered care. CONCLUSIONS: The clinical implications of these findings are two-fold. First, PCPs' needs cannot be ignored when considering pain care. PCPs need support, both instrumental and emotional, as they care for patients with chronic pain. Second, improving PCPs' patient-centered communication skills-including demonstrating empathy and encouraging shared decision-making-holds promise for alleviating some of the strain and burden reported by providers, ultimately leading to improved patient care.

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Medical providers have reported that the absence of evidence based guidelines, limited support for clinicians and the emotional toll of working with women who have PPP are key barriers to providing appropriate care.
“Medical providers have also reported that the absence of evidence based guidelines, limited support for clinicians and the emotional toll of working with women who have PPP are key barriers to providing appropriate care.30”
From Psychological interventions for women with persistent pelvic pain: A survey of mental health clinicians (2021) · cites this paper as [30]

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Authors: Matthias, M. S., Parpart, A. L., Nyland, K. A., Huffman, M. A., Stubbs, D. L., Sargent, C., & Bair, M. J.
Affiliations: Richard L. Roudebush VA Medical Center (US)
VA NY Harbor Healthcare System (US)
Indiana University Indianapolis (US)
Corresponding author: Matthias, Marianne S.
ORCID: Matthias, Marianne S.
Bair, Matthew J.
Venue: Pain Medicine
Publisher: Oxford University Press (OUP)
Published: 2010-11
Volume: 11
Issue: 11
Pages: 1688-1697
ISSN: 1526-2375 (ISSN-L)
1526-4637
DOI: 10.1111/j.1526-4637.2010.00980.x
OpenAlex: W1794110802
Cited by: 298
References: 67
Citations by year: 2026: 15 · 2025: 11 · 2024: 13 · 2023: 14 · 2022: 16 · 2021: 28 · 2020: 25 · 2019: 27 · 2018: 24 · 2017: 21 · 2016: 26 · 2015: 16 · 2014: 19 · 2013: 18 · 2012: 16
FWCI: 22.15
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1 (tdm, 1765 d)
Locations: Pain Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords: chronic pain, patient-provider relationship, primary care providers, provider perspectives, opioid prescribing, secondary gain, difficult patients, patient-centered care, shared decision-making, empathy, veterans
MeSH terms: Adult, Chronic Disease, Female, Health Personnel, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Nurse Practitioners, Pain, Pharmacists, Physicians, Professional-Patient Relations, Patient-Centered Care

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The Patient–Provider Relationship in Chronic Pain Care: Providers' Perspectives

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