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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald


CiteScore 2018: 0.85

SCImago Journal Rank (SJR) 2018: 0.494
Source Normalized Impact per Paper (SNIP) 2018: 0.427

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1877-8879
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Volume 17, Issue 1

Issues

Patient perspectives on wait times and the impact on their life: A waiting room survey in a chronic pain clinic

Clare Liddy
  • Corresponding author
  • C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
  • Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Patricia A. Poulin
  • Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  • The Ottawa Hospital, Department of Psychology, Ottawa, Ontario, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Zoë Hunter
  • C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Catherine Smyth
  • Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Erin Keely
  • Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-10-01 | DOI: https://doi.org/10.1016/j.sjpain.2017.07.015

Abstract

Background and Aims

Chronic pain is a debilitating condition that requires prompt access to care for effective treatment. Wait times for care often exceed benchmark recommendations, with potential consequences to patient health outcomes. The goal of this paper is to gain the perspectives of patients attending a chronic pain clinic regarding the acceptability of current wait times and the impact of their experiences of waiting for chronic pain care.

Methods

The study took place in a chronic pain clinic at an academic-affiliated teaching hospital in Ottawa, Canada, which housed seven clinicians at the time of the study. New patients attending the chronic pain clinic between July 14, 2014 and August 5, 2015 were eligible to participate based on the availability of the research and clerical staff who administered the survey on a variety of days over the course of the study. Patients completed a self-administered 29-item survey. The survey took approximately five to ten minutes to complete. Questions pertained to patients’ socioeconomic factors, chronicity and burden of pain symptoms, and satisfaction with current wait times. Actual wait times were self-reported. Survey results were entered into an Excel spreadsheet, exported to SPSS, and coded numerically to facilitate descriptive analyses using comparative graphs and tables. Open-text responses were reviewed by the authors.

Results

Sixty-six patients completed the survey. While 83% of patients stated that their ideal wait time was less than three months, 32% reported receiving an appointment within this period, and 31% reported waiting a year or more. Only 37% of patients felt the wait time for their appointment was appropriate. During their wait,41% of patients reported receiving written information about chronic pain and 47% were referred to a local chronic pain management group. 94% reported interference with social/recreational activities and normal activities of daily living, 31% had to miss work or school due to the frequency of ongoing symptoms, and 22% reported being unable to attend work or school altogether. Furthermore, 37% of patients reported visiting the emergency room within the previous year and 65% worried about having a serious undiagnosed disease.

Conclusions

Our study found that wait times for chronic pain care, even those triaged as urgent cases, far exceeded what patients considered ideal. Only a third of patients received care within three months of making their appointment, while nearly another third waited over a year. During the waiting period, nearly all patients experienced some impact on their day-to-day activities and work or school attendance, half were unemployed, and nearly a quarter reported a complete inability to attend work or school because of pain.

Implications

Wait times for chronic pain care exceed timelines deemed acceptable by patients, causing anxiety and reducing function. The patient perspective must be considered in initiatives attempting to improve access to care for this population with specific needs and goals. Innovative solutions, such as electronic consultation and shared care models, hold promise.

Keywords: Chronic pain; Wait times; Patient perspectives; eConsult

References

  • [1]

    Andrew R, Derry S, Taylor RS, Straube S, Phillips CJ. The costs and consequences of adequately managed chronic non-cancerpain and chronic neuropathic pain. Pain Pract 2014;14:79–94.CrossrefPubMedGoogle Scholar

  • [2]

    Institute of Medicine (US).Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington: National Academies Press; 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK91497/[accessed 29.03.17].

  • [3]

    Tang NK, Crane C. Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links. Psychol Med 2006;36:575–86.PubMedCrossrefGoogle Scholar

  • [4]

    Choiniere M, Dion D, Peng P, Banner R, Barton PM, Boulanger A, Clark AJ, Gordon AS, Guerriere DN, Guertin MC, Intrater HM, Lefort SM, Lynch ME, Moulin DE, Ong-Lam M, Racine M, Rashiq S, Shir Y, Taenzer P, Ware M. The Canadian STOP-PAIN project - Part 1: Who are the patients on the waitlists of multidisciplinary pain treatment facilities? Can J Anesth 2010;57:539–48.Web of ScienceCrossrefGoogle Scholar

  • [5]

    Wait Time Alliance. Wait Time Benchmarks for Patients with Chronic Pain; 2014. Available from: http://www.waittimealliance.ca/benchmarks/chronic-pain/[accessed 29.03.17].

  • [6]

    Canadian Anesthesiology Society. Wait Time Benchmarks for patients with Chronic Pain: Position of the Canadian Anesthesiologists Society. Ottawa: Wait Time Alliance; 2014. Available from: http://www.waittimealliance.ca/wp-content/uploads/2014/05/Position-of-the-Section-of-Chronic-Pain-on-Wait-Lists-Version-2012–1.pdf [accessed 29.03.17].

  • [7]

    Lynch ME, Campbell F, Clark AJ, Dunbar MJ, Goldstein D, Peng P, Stinson J, Tupper H. Asystematic review of the effect ofwaiting fortreatment forchronic pain. Pain 2008;136:97–116.CrossrefGoogle Scholar

  • [8]

    Peng P, Choiniere M, Dion D, Intrater H, Lefort S, Lynch M, Ong M, Rashiq S, Tkachuk G, Veillette Y. STOPPAIN Investigators Group. Challenge in accessing multidisciplinary pain treatment facilities in Canada.Can J Anaesth 2007;54:977–84.Google Scholar

  • [9]

    Meghani SH, Byun E, Gallagher RM. Time to take stock: a meta-analysis and systematic review of analgesic treatment disparities for pain in the United States. Pain Med 2012;13:150–74.CrossrefGoogle Scholar

  • [10]

    Davis K, Schoen C, Stremikis K, Fund C. Mirror, mirror on the wall: How the performance of the US health care system compares internationally: 2010 update. New York, NY: The Commonwealth Fund; 2010. Available from: http://www.resbr.net.br/wp-content/uploads/historico/Espelhoespelhomeu.pdf [accessed 29.03.17].

  • [11]

    Liddy C, Drosinis P, Keely E. Electronic consultation systems: worldwide prevalence and their impact on patient care - a systematic review. Fam Pract 2016;33:274–85.Web of SciencePubMedCrossrefGoogle Scholar

  • [12]

    Liddy C, Smyth C, Poulin PA, Joschko J, Rebelo M, Keely E. Improving access to chronic pain services through econsultation: a cross-sectional study of the Champlain BASE eConsult Service. Pain Med 2016:nw038.Web of ScienceCrossrefGoogle Scholar

  • [13]

    Keely E, Traczyk L, Liddy C. Patient perspectives on wait times and the referral-consultation process while attending a tertiary diabetes and endocrinology centre: Is eConsultation an acceptable option? Can J Diabetes 2015;39: 325–9.CrossrefPubMedGoogle Scholar

  • [14]

    Lynch ME, Campbell FA, Clark AJ, Dunbar MJ, Goldstein D, Peng P, Stinson J, Tupper H. Canadian Pain Society Wait Times Task Force. Waiting for treatment for chronic pain – a survey of existing benchmarks: toward establishing evidence-based benchmarks for medically acceptable waiting times.Pain Res Manag 2007;12:245.Google Scholar

  • [15]

    Guerriere DN, Choiniere M, Dion D, Peng P, Stafford-Coyte E, Zagorski B, Banner R, Barton PM, Boulanger A, Clark AJ, Gordon AS, Guertin MC, Intrater HM, Lefort SM, Lynch ME, Moulin DE, Ong-Lam M, Racine M, Rashiq S, Shir Y, Taenzer P, Ware M. The Canadian STOP-PAIN project-Part 2: What is the cost of pain for patients on waitlists of multidisciplinary paintreatment facilities? Can J Anesth 2010;57:549–58.CrossrefGoogle Scholar

  • [16]

    Turk DC, Dworkin RH, Revicki D, Harding G, Burke LB, Cella D, Cleeland CS, Cowan P, Farrar JT, Hertz S, Max MB, Rappaport BA. Identifying important outcome domains for chronic pain clinical trials: an IMMPACT survey of people with pain. Pain 2008;137:276–85.CrossrefWeb of SciencePubMedGoogle Scholar

  • [17]

    Davies S, Quintner J, Parsons R, Parkitny L, Knight P, Forrester E, Roberts M, Graham C, Visser E, Antill T, Packer T, Schug SA. Preclinic group education sessions reduce waiting times and costs at public pain medicine units. Pain Med 2011;12:59–71.PubMedWeb of ScienceCrossrefGoogle Scholar

  • [18]

    Cousins MJ, Lynch ME. The Declaration Montreal: access to pain management is a fundamental human right. Pain 2011;152:2673–4.CrossrefWeb of SciencePubMedGoogle Scholar

  • [19]

    Merolli M, Gray K, Martin-Sanchez F, Lopez-Campos G. Patient-reported outcomes and therapeutic affordances of social media: findings from a global online survey ofpeople with chronic pain. J Med Internet Res 2015;17:e20.CrossrefGoogle Scholar

  • [20]

    Ranney ML, Duarte C, Baird J, Patry EJ, Green TC. Correlation of digital health use and chronic pai coping strategiesm. Health 2016;2.Google Scholar

  • [21]

    Liddy C, Rowan MS, Afkham A, Maranger J, Keely E. Building access to specialist care through e-consultation. Open Med 2013;7:e1–8.PubMedGoogle Scholar

About the article

Bruyère Research Institute, 43 Bruyère St, Annex E, Room 106, Ottawa, ON K1N 5C8, Canada


Received: 2017-05-08

Revised: 2017-06-14

Accepted: 2017-07-07

Published Online: 2017-10-01

Published in Print: 2017-10-01


Ethical issues: This study did not involve any patient intervention and informed consent was not required. Ethics approval for the study was provided by The Ottawa Health Science Network Research Ethics Board.

Conflict of interest: None.

Role of funding source: Funding for this project was provided by the Ontario Ministry of Health and Long-Term Care, The Ottawa Hospital Academic Medical Organization Innovation Fund, e-Health Ontario, and the Champlain Local Health Integration Network. The funders had no role in the design of the study; the collection, analysis, or interpretation of the data; the writing of the article; or the decision to submit the article for publication.


Citation Information: Scandinavian Journal of Pain, Volume 17, Issue 1, Pages 53–57, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2017.07.015.

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