Experiences and Expectations: findings from focus groups of older people attending pain clinics.

1. Experiences and Expectations: findings from focus groups of older people attending pain clinics. On behalf of the EOPIC Team: Dr Derek Jones1, Professor Denis Martin2, Dr Pat Schofield3, Dr Paul McNamee4, Geraldine Anthony4, Dr Amanda Clarke1, Professor Blair Smith5 1 Northumbria University, 2 Teesside University Institute of Health & Social Care, 3 Universityof Greenwich, 4 University of Aberdeen Centre of Academic Primary Care & Health Economics Research Unit, 5University of Dundee. IASP Milan 2012 PH 214 Findings • Analysis to date indicates a diversity of expectations and experiences; the only shared experience emerging strongly has been satisfaction gained from participating in the focus group (having the opportunity to hear the story of others in similar circumstances). Aims To explore the treatment expectations and experiences of older adults attending pain clinics. • Although there is evidence of stoicism in the face of pain we found our participants readily spoke of the distress and difficulties associated with their pain. The interpersonal skills of professionals did have an impact for some participants on the extent to which they discussed these issues in the clinical setting. The care pathway to the pain clinic was typically a complex one and often represented the end of a long journey following diagnosis of a primary condition. This was typically expressed as a frustrating process rather than one which engendered a sense of uncertainty around their pain, its cause, and diagnosis. Methods • 3 focus groups were undertaken in NE Scotland (n=20) and 3 in NE England (n=20). • Participants included males and females and ranged in age from 68-87; diagnoses included conditions with nociceptive and/or neuropathic pain as a feature. • All participants were recruited from local pain clinics. • Groups were audio taped and group co-facilitators made contemporaneous notes. Data from these two sources were subject to descriptive content analysis and thematic analysis (this iterative process is still in progress). • The topic schedule for the focus groups addressed the following issues: referral to pain clinic, prior expectations and actual experience of the pain clinic, advice they would give to others referred to a pain clinic, experience of participation in the focus group. Views on pharmacological interventions were mixed with some positive experiences reported but also some strong concerns about polypharmacy and opioids (referred to as ‘hill-billy heroin’ by one participant). A common feeling was that (until attendance at the pain clinic) “…all they give you is pills…” Conclusions The interpersonal skills of professionals influences the expression of stoicism. Older people attending pain clinics take a pragmatic approach to pain management and are willing to trial proposed interventions despite some concerns about pharmacological approaches. Access to pain clinics in terms of early referral, frequency of appointments, and geographical location is worthy of further investigation. Participation in the focus groups was valued and suggests opportunities for peer support should be developed. A second emerging theme relates to the degree to which participants would be willing to accept frequent interventions with short lived benefits because of the pain relief obtained. Lack of easy access to pain clinics (in terms of frequency of appointments and geographical location ) was highlighted as a negative issue and presented in the context of the short but welcomed relief provided by interventions available. Engaging Older People and their carers to develop Interventions for the self-management of Chronic pain This study was funded by LLHW initiativeMRC Award Ref G0900684/2 EOPIC