1. Deborah K. Nelson, Psy.D. Patient Perspectives on Pain Medications Deborah K. Nelson, M.A. Patient Perspectives on Pain Medications

2. Disclosures Deborah Nelson has disclosed no financial relationships that may pose a conflict of interest. There will be no unannounced disclosures of off-label use of drugs, biologics or medical devices.

3. Background Dissertation on older adults and their perceptions of pain medications. Objective was to understand the reasons for taking or not taking their pain medications. Strategy was in-home, semi-structured interviews. Analyzed for themes and used to produce DVD.

4. Major Findings Pain management, from the patient’s perspective, is complex and idiosyncratic. Key to understanding each patient’s process is to understand their individual goals and values. Just as the pain interfered with each subject’s life goals, so too did the pain medications.

5. Scenario Many visit doctor with pain complaints. Doctors appointments are short. Patients are often quickly prescribed pain medication. Even patients who are happy with their physician are frustrated by this experience.

6. Ambivalence Towards the Pain Medications Patient returns home with a prescription for pain medication, but is ambivalent about taking it. Ambivalence is driven by: Fear of addiction Fear of side effects Too many pills

7. Fear of Addiction Most frequently mentioned among the study’s participants -- regardless of family or personal history of addiction.

8. Fear of Side Effects Most common side effects mentioned: dopiness dizziness / unsteadiness on feet dryness headaches and stomach troubles Salience of side effect(s) varied from individual to individual and was tied to goals for the day (e.g. resting versus driving a car).

9. Too Many Pills Everyone in this study was taking other medication for a variety of health issues. Medication burden concerns primarily related to: the physical requirement to consume so many pills concerns about a variety of drugs in their body

10. Tough Choices Patients ask themselves the following questions: How long will the pain last? How severe will it get? What activities do I need / want to do? If I take the pain medication, how much will the pain be reduced and for how long? What will the side effects be and can I manage them?

11. Other Research Findings After taking the pain medication, many patients felt frustration and anger. Socioeconomic differences.

12. Concluding Remarks Pain management is complex and idiosyncratic – for both the patient and the physician. Key to understanding each patient’s process is to understand their individual goals and values. Fears and lack of knowledge result in ambivalence. Patients want more assistance / support in making pain management and medication decisions. Patients want a more cautious and thorough approach to pain management.

13. Thank You Deborah K. Nelson, Psy.D. PSY 27324 debnelsonpsyd@gmail.com © Deborah K. Nelson, Psy.D.