Investigating the barriers to effective management of musculoskeletal pain: an international survey

An international study was performed to investigate the discrepancy between physician and population perception of the management of musculoskeletal pain (MP). One thousand, one hundred and fifty-four people with MP and 604 primary care physicians randomly selected from six countries (UK, Germany, Italy, France, Australia and Mexico) were interviewed by telephone. The interviews were based on structured questionnaires that captured: the management of pain, knowledge about the condition, sources of information, information communicated within the consultation, and patient roles in pain management. People with MP are confused about the different treatment options available (up to 63% out of N=1,154) to them and their relative benefits and risks (33-51%). Doctors are the most valued and appropriate source of information (by up to 80% of people, N=1,154) but are difficult to access. When people do have a clinical consultation, there may be a disparity between the information doctors convey and patient recall of the information provided. For example, most doctors tell patients the number of tablets they will need to take to achieve optimal pain relief, but only 34-63% of people with MP recall being given this information. Lack of information may partially explain why so few people (7-36%) return to their doctor when their prescribed medication is ineffective. This survey identified lack of information as a potential barrier to effective treatment. Physicians' perceptions that people with MP are not able to appraise all the information and may prefer a passive role in their care need to be challenged if patients are to be participants in the management of their condition.