Issues Magazine

Fight Against Pain Relies on Doctor–Patient Communication


International Association for the Study of Pain

Good doctor–patient communication can improve adherence rates to pain medication and can help fight against pain. Over 7800 experts gathered in Milan at the International Association for the Study of Pain’s 14th World Congress on Pain in 2012 to hear the latest about pain research and management, including a plenary highlighting the importance of fostering a new culture for healthcare professionals and patients based on listening and talking about pain. Good health care professional–patient communication is crucial to the success of pain medication and management, with enormous savings for the healthcare system and improvements in the quality of life of patients.

“Patient adherence rates to pain medication are poor, and this is linked to the way patients think about pain medication, the way they feel, and what they experience physically when they take pain medication,” explained Dr Phyllis Butow, Co-Director of the Centre for Medical Psychology & Evidence-based Decision-making), and chair of the Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney. “Patients don’t like taking pills, they worry about side-effects and about addiction to pain medication. Patients worry that admitting pain reflects a weak character. Doctor–patient communication is key to encourage patients to talk about their pain, reassure them to address misconceptions and barriers and to identify what is most important to them in managing their pain and tailoring pain medication,” said Dr Butow, who delivered a plenary address at the World Congress on Pain.

Dr Butow outlined three goals to optimise doctor–patient communication and increase adherence to pain medication:

  • Actively ask about pain and reassure. It’s necessary to listen carefully and respond to patients’ concerns. Ask them if they feel pain, find out how intense and persistent the pain is, and understand if they’re worried about implications of their pain in order to independently address the issue.
  • Involve patients. “It’s important to create active collaboration between doctor and patient,“ adds Dr Butow. “Patients who feel that they have been involved in the decision about their pain management are more likely to stick to it, and they are also more likely to feel empowered to do something about their pain.”
  • Involve family members. “If patients feel their family does not believe they are in pain, or disapprove of opioid use, they are less likely to take it. Educating the family is often as important as educating the patient,” Dr Butow comments.

The importance of doctor–patient communication is also witnessed by an inverse proportion between the level of education and the level of pain persistence. This could be explained by the better capability of a highly educated person to communicate with a doctor.