Understanding General Practitioner and Patient Perceptions Regarding Integration of Non-Pharmacological Interventions in Chronic Non-Cancer Pain Management—A Cross-Sectional Mixed-Methods Study in the RELIEF Project

TL;DR

This study explores how doctors and patients in Germany view the use of non-drug treatments for chronic pain, finding differences in their perceptions and highlighting the need for better communication.

Contribution

The study provides new insights into the integration of non-pharmacological interventions in general practice from both physician and patient perspectives.

Findings

Patients often initiate non-pharmacological interventions themselves and are aware of bio-psycho-social factors.

Physicians commonly recommend physiotherapy and psychotherapy but less frequently discuss social and physical activities.

Communication and integration of holistic pain management need improvement between doctors and patients.

Abstract

Background: Chronic non-cancer-related pain is an independent condition with a multicausal genesis. Guidelines highlight the need for holistic treatment based on the bio-psycho-social model. While prescribing medication is common, it remains unclear how and to what extent non-pharmacological interventions are considered and recommended in general practice pain management. The project RELIEF explored the integration of non-pharmacological interventions in general practices in Germany from both physician and patient perspectives. Methods: A mixed-methods study collected data with patients and general practitioners via semi-structured telephone interviews and self-developed questionnaires. Qualitative data were analyzed in a reflexive thematic analysis. Survey data were analyzed descriptively. Results: N = 383 questionnaires (n = 131 general practitioners, n = 252 patients) and n = 61 interviews (n = 21 general practitioners, n = 40 patients) were analyzed. Patient and physician perceptions regarding the integration of non-pharmacological interventions differed. Patients felt pharmacological therapy was recommended primarily, applied non-pharmacological interventions based on their own initiative, and were aware of bio-psycho-social interrelations. Physicians perceived that they often recommended physiotherapy and psychotherapy alongside analgesics, and asked about non-pharmacological interventions (79.4%), explained the bio-psycho-social chronic pain genesis (55.7%), and provided information on physical (48.9%) and social (35.9%) activity, relaxation techniques (42%), topical applications (31.9%), and support groups (25.2%). Conclusions: The integration of holistic pain management and communication between patients and general practitioners appear to need strengthening.

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