(221) - A prospective study of patient satisfaction with communication regarding chronic pain in the primary care setting: Do opioid prescriptions matter?

Abstract

Patient satisfaction ratings are a core quality benchmark of health care delivery. Anecdotal reports suggest that patient satisfaction may increase when patients are prescribed an analgesic, specifically opioids. Clinician beliefs that prescribing analgesics will increase patient satisfaction ratings could lead to overprescribing. To identify clinical factors associated with patient satisfaction with patient-provider communication, we surveyed chronic pain patients who had visited a primary care provider a week prior. We identified chronic pain patients using ICD-10 codes in EPIC and delivered the survey to patients using the Research Electronic Data Capture system. The survey asked patients “How satisfied were you with your discussion with your provider regarding your pain?” and “Have you been experiencing pain for more than three months?” A list of active analgesic prescriptions and 0–10 NRS pain ratings were extracted from EPIC using the Informatics for Integrating Biology and the Bedside software. 14,629 patients were identified over 3 months; 1227(8%) patients responded. In a multivariate model, higher pain scores (OR [95% CI]: 1.10 [1.04–1.15], P = .0003) and longer pain duration (>3 months vs. <3 months OR: 1.96 [1.23–3.14], P = .003) were associated with lower satisfaction; opioid prescription was not significantly associated with lower satisfaction (opioid vs. no opioid OR: 1.45 [.96–2.19], P = .07). However, considering the CI, the data are consistent with a possible association between opioids and lower satisfaction, but not higher satisfaction. These data suggest that an opioid prescription alone is not likely to improve patient satisfaction. Furthermore, it suggests that clinicians who treat patients with worse pain or who've had pain for longer duration may receive lower satisfaction scores compared to other clinicians regardless of the quality of the care that they deliver. Methods like the one presented here that integrate patient satisfaction scores with clinical characteristics could provide improved health care benchmarks. This research was supported by Pfizer.