PT  - JOURNAL ARTICLE
AU  - May, Curtis
AU  - Peterson, Sandra
AU  - Gooderham, Ellie
AU  - Hedden, Lindsay
AU  - McCracken, Rita K.
AU  - Lavergne, M. Ruth
TI  - Chronic pain management in primary care
AID  - 10.46747/cfp.7009570
DP  - 2024 Sep 01
TA  - Canadian Family Physician
PG  - 570--579
VI  - 70
IP  - 9
4099  - http://www.cfp.ca/content/70/9/570.short
4100  - http://www.cfp.ca/content/70/9/570.full
SO  - Can Fam Physician2024 Sep 01; 70
AB  - Objective To examine trends in chronic pain (CP) practice patterns among community-based family physicians (FPs).Design Population-based descriptive study using health administrative data.Setting British Columbia from fiscal years 2008-2009 to 2017-2018.Participants Patients with an algorithm-defined CP condition and community-based FPs, both registered with the British Columbia Medical Services Plan.Main outcome measures Using British Columbia health administrative data and a CP algorithm adapted from a previous study, the following were compared between fiscal years 2008-2009 and 2017-2018: CP patient volumes, pain-related medication prescriptions, referrals to pain specialists, musculoskeletal imaging requests, and interventional procedures.Results In the fiscal year 2017-2018, among community-based family physicians (N=4796), an average of 32.5% of their patients had CP. Between 2008-2009 and 2017-2018, the proportion of CP patients per FP who were prescribed long-term opioids increased by an average absolute change of 0.56%; the proportion prescribed long-term neuropathic pain medications increased by 1.1%; and the proportion prescribed long-term nonsteroidal anti-inflammatory drugs decreased by 0.49%. The proportion of musculoskeletal imaging out of all imaging requests made by FPs increased by 2.0%; pain-related referrals increased by 1.73%; there was a 4.6% increase in the proportion of community-based FPs who performed 1 or more pain injections; and 10% more FPs performed 1 or more trigger point injections within a fiscal year.Conclusion Findings show that the work of providing care to patients with CP increased while CP patient volumes per FP decreased. Workforce planning for community-based FPs should consider these increased demands and ensure FPs are adequately supported to provide CP care.