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

Clare Liddy 1 , 2 , Patricia A. Poulin 3 , 4 , 5 , Zoë Hunter 1 , Catherine Smyth 3 , 4  and Erin Keely 6 , 7
  • 1 C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
  • 2 Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • 3 Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • 4 The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  • 5 The Ottawa Hospital, Department of Psychology, Ottawa, Ontario, Canada
  • 6 Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • 7 Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada
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
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, 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
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, Zoë Hunter
  • C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
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, Catherine Smyth
  • Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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and Erin Keely
  • Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada
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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.

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