Patient Perspectives of Acute Pain Management in the Era of the Opioid Epidemic

In the Annals of Emergency Medicine, Robert Smith and colleagues, including Karin Rhodes and Zachary Meisel, analyze patient perspectives on pain management, use of opioids, and understanding of the risks of developing opioid dependence. The authors conducted semi-structured telephone interviews with 23 patients recently discharged from an urban academic emergency department after presenting with acute back pain. Although patients discussed many topics, themes arose around: awareness of opioid dependence and addiction, and patient-provider communication around pain management. Patients expressed a desire to be more involved in the decision-making process around their pain management. Patients who had positive experiences commented on regular communication with their care team, rapid pain management, and the empathetic nature of their care providers. Patients additionally communicated fears about the risks of opioid addiction and an understanding of the broader tensions that providers face relating to the prescription of opioid therapy. The authors conclude that a patient’s overall experience is not guided by mere satisfaction or dissatisfaction with pain management. Rather dynamics of provider empathy, care coordination, active patient-provider communication, and patient agency all contribute to a patient’s understanding of their pain and pain management strategies.