An evaluation of family medicine residents' attitudes before and after a PCMH innovation for patients with chronic pain

Abstract

Background and objectives: Prior research indicates that primary care physicians have predominantly negative attitudes toward chronic pain patients, and chronic pain patients have predominantly low satisfaction with the care and treatment they receive in primary care. This current state of affairs highlights the need for Patient-centered Medical Home (PCMH) innovations for the treatment of chronic pain in primary care. The purpose of this study was to determine if a PCMH innovation for the treatment of chronic pain in a family medicine residency program can improve resident attitudes toward chronic pain patients.

Methods: From January 2010 to December 2010, 30 family medicine residents (two--three per month) participated in twice-a-month PCMH innovation for the treatment of chronic pain in primary care ("pain clinic"). De-identified data from a Likert-type measure of negative attitudes toward chronic pain patients were extracted from pain clinic evaluation information that was collected shortly before (pretest) and shortly after (posttest) the residents' pain clinic participation. Using these data, we conducted a paired-samples t test to determine if residents' negative attitudes toward chronic pain patients had improved.

Results: The difference between residents' pretest scores (M=51.2, SD=10.9) and posttest scores (M=45.2, SD=9.2) was significant, suggesting that residents' negative attitudes toward chronic pain patients improved after participating in pain clinic.

Conclusions: A PCMH innovation for the treatment of chronic pain in primary care can improve family medicine residents' attitudes toward chronic pain patients.