Current practices of health care providers in recommending online resources for chronic pain self-management

Abstract

Hemakumar Devan,1 Hazel K Godfrey,1,2 Meredith A Perry,1 Dagmar Hempel,3 Barbara Saipe,3 Leigh Hale,4 Rebecca Grainger51Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Wellington, New Zealand; 2School of Psychology, Victoria University of Wellington, Wellington, New Zealand; 3Pain Management Service, Capital and Coast District Health Board (CCDHB), Wellington, New Zealand; 4Centre for Health, Activity and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Dunedin, New Zealand; 5Department of Medicine, University of Otago, Wellington, New ZealandPurpose: Online health resources (websites, apps and social media) may be an adjunct to provide self-management support for people with persistent or chronic pain. Endorsement of online health resources by health care providers is crucial for uptake by end-users. The aim of this study was to investigate the current practices of New Zealand (NZ) health care providers in recommending online resources for persistent pain management, and to identify what factors predict health care providers’ recommendations and to explore the common concerns.Methods: An online survey of NZ health care providers (ie, chiropractors, general practitioners, nurses, occupational therapists, osteopaths, physiotherapists, psychologists, specialist consultants, and social workers) involved in the management of persistent pain was conducted. The recruitment strategy was tailored to each occupation via occupation-specific professional organizations, and by approaching multidisciplinary professional organizations.Results: Data from 213 health care providers were used in the final analysis. Most of the health care providers were physiotherapists (n=71), followed by chiropractors (n=39) and general practitioners (n=31). Fifty three percent (111/210) of health care providers reported currently recommending online resources. A multivariate logistic regression model showed that specialist interest in treating pain (OR=3.84; 95% CI: 1.66, 8.87; P=0.002), and level of confidence in recommending online resources (OR=1.05; CI: 1.04, 1.07; P<0.001), positively influenced recommending online resources. The majority of the health care providers (65%, 138/213) were concerned about the safety issues related to the risk of patients misinterpreting online information and to the lack of evidence-based information. Conclusion: Half of the health care providers surveyed reported recommending online resources, which may suggest limited confidence in recommending, or knowledge of, existing online resources for persistent pain management. Ongoing education for health care providers on evidence-based online resources is required to recommend online resources as a self-management support tool for people with persistent pain.Keywords: chronic pain, clinical practice, eHealth, mHealth, mixed methods, survey

Keywords

• chronic pain
• clinical practice
• eHealth
• mHealth
• mixed methods
• survey