Needs and Preferences of Dutch Chronic Pain Patients: the Lack of Continuity and Guided Care.

Abstract

Background: Chronic pain is common in many patients, sometimes without a clear cause. However, pain is not a medical specialty in the Netherlands. It is therefore of interest to see what care these patients receive and how they perceive the care received. Methods: Mixed methods using focus group discussions and IPA method for analyses in developing a structured Consumer Quality Index questionnaire (CQI). Findings: 23 chronic pain patients took part in four focus groups, 886 completed the survey (RR=40%; 73% women). Patients reported lack of continuity in care and poor coordination between healthcare providers. Though most reported fairly good doctor-patient communication, about 25% reported limited shared decision-making and 35% limited information sharing about treatment possibilities. Many made use of complementary medical care, due to restricted health care insurance coverage of standard care. Discussion: Chronic pain patients would benefit of health-care providers being more proactive and some central healthcare-professional coordinating the chronic pain care, e.g. a case manager. Complementary care was found useful, though standard care was believed to be most beneficial.