Patient expectations for chronic pain management

INTRODUCTION: In New Zealand, one in six people report chronic pain, but the literature indicates only a 30% pain reduction is typically achieved in about half of treated patients. Most patients expecting a cure of their pain, or even substantial pain reduction, are therefore likely to be disappointed. It is important to align patient expectations with this reality. METHODS: This study analysed the responses of 250 patients referred to a Pain Management Centre to the free-text question: 'What are your main goals or reasons for attending the Pain Management Centre?' Free-text comments were analysed using ethnographic content analysis, an inductive approach in which the themes and subthemes are not predetermined, but emerge from the data during analysis, and thus reflect the issues of importance to patients themselves. FINDINGS: Three themes emerged from the analysis: patients' desire to understand their pain, regain 'normality', and concerns about medication. Responses were divided into those with an expectation of cure, and those who seemed to be more accepting of their pain and who desired management. CONCLUSION: Patients hope to return to what they perceive as normal and to have clear, relevant information about their diagnosis, prognosis and medications. Those desiring cure, or significant pain reduction, present more of a challenge to their general practitioners and the Pain Management Centre. When referring a patient for chronic pain management, there is a need to align patient expectations at the point of referral with what can realistically be achieved.