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      Counseling interactions between patients living with persistent pain and pharmacists in Australia: are we on the same page?

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          Abstract

          Background

          People living with persistent pain in Australia often cannot access adequate care to manage their pain. Therefore, as the most accessible healthcare professionals, community pharmacists have an important role to play in helping to improve patient outcomes. Hence, it is important to investigate patient needs and expectations in terms of counseling interactions with pharmacists, along with pharmacists’ approach to counseling interactions with these patients.

          Method

          The nature of patient–pharmacist counseling interactions was explored with seven patients (one focus group), and 10 practicing pharmacists (two focus groups, three semi-structured interviews). The themes identified informed the development of an online survey that was advertised online to patients and pharmacists across Australia.

          Results

          A total of 95 patients and 208 pharmacists completed the survey. Overall, more than half of patients (77/95) were satisfied with the care provided by their pharmacist, but only a third (71/205) of pharmacists were satisfied with the care they provided to patients. The majority of patients (67/94) reported that pharmacists provided good information about medications. This aligned with pharmacists’ responses, as most reported focusing on medication side effects (118/188) and instructions for taking pain medication (93/183) during patient interactions. However, when asked about empathy and rapport from pharmacists, only half to two-thirds (48–61/95) of patients expressed positive views. Overall, half of the patients (39/75) wanted a caring, empathetic, respectful, and private conversation with the pharmacist, and nearly half (40/89) perceived the pharmacist's role as providing (new) information on alternative pharmacological and non-pharmacological therapies, including general advice on pain management.

          Conclusion

          There was a disparity in the nature of the interaction and information that patients wanted from pharmacists, compared to what was provided by pharmacists. Training and education may help pharmacists to better engage in patient-centered care when interacting with people living with persistent pain, thereby improving health outcomes for these patients.

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          Most cited references 30

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          The costs and consequences of adequately managed chronic non-cancer pain and chronic neuropathic pain.

          Chronic pain is distressing for patients and a burden on healthcare systems and society. Recent research demonstrates different aspects of the negative impact of chronic pain and the positive impact of successful treatment, making an overview of the costs and consequences of chronic pain appropriate.
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            Pain self-efficacy beliefs and pain behaviour. A prospective study.

            This study examined the relationship between pain self-efficacy beliefs and a range of pain behaviours, as measured by the pain behaviour questionnaire (PBQ), using a prospective design. A heterogeneous sample of 145 chronic pain patients completed sets of questionnaires on four occasions over a nine-month period. Multiple hierarchical regression analyses revealed that the subjects' confidence in their ability to perform a range of tasks despite pain (assessed at baseline), was predictive of total pain behaviour and avoidance behaviour over the nine-month study period. This finding was particularly significant because the analyses controlled for the possible effects of pain severity (at each measurement occasion), pain chronicity, age, gender, physical disability, depression, neuroticism and catastrophising. These findings suggest that pain self-efficacy beliefs are an important determinant of pain behaviours and disability associated with pain, over and above the effects of pain, distress and personality variables. In particular, higher pain self-efficacy beliefs are predictive of reduced avoidance behaviours over an extended period.
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              The patient-provider relationship in chronic pain care: providers' perspectives.

              Pain is the most commonly reported symptom in primary care and is a leading cause of disability. Primary care providers (PCPs) face numerous challenges in caring for patients with chronic pain including communication and relational difficulties.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                JPR
                jpainres
                Journal of Pain Research
                Dove
                1178-7090
                05 August 2019
                2019
                : 12
                : 2441-2455
                Affiliations
                [1 ] School of Clinical Sciences, Queensland University of Technology , Brisbane, QLD, Australia
                [2 ] School of Pharmacy, University of Queensland , Brisbane, QLD, Australia
                [3 ] Clinical Research Center, Sarawak General Hospital , Kuching, Sarawak, Malaysia
                Author notes
                Correspondence: Yasmin J AntwertingerFaculty of Health , Lvl 9, Q block, Gardens Point Campus, QUT, Brisbane, QLD4000, AustraliaTel +617 3138 4824Email yasmin.antwertinger@qut.edu.au
                Article
                199017
                10.2147/JPR.S199017
                6689145
                © 2019 Lau et al.

                This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Figures: 1, Tables: 5, References: 44, Pages: 15
                Categories
                Original Research

                Anesthesiology & Pain management

                pharmacist, counseling, pain, persistent, chronic

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