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Pain Research and Management
Volume 19 (2014), Issue 5, Pages 241-250
Original Article

Knowledge, Attitudes and Beliefs about Chronic Noncancer Pain in Primary Care: a Canadian Survey of Physicians and Pharmacists

Lyne Lalonde,1,2,3,4 Vincent Leroux-Lapointe,4,5 Manon Choinière,3,6 Elisabeth Martin,3,4 David Lussier,7,8 Djamal Berbiche,3,4 Diane Lamarre,1,9 Robert Thiffault,10 Ghaya Jouini,3,4 and Sylvie Perreault1,11

1Faculty of Pharmacy, Université de Montréal, Montreal, Canada
2Sanofi Aventis Endowment Chair in Ambulatory Pharmaceutical Care, Université de Montréal and Centre de santé et de services sociaux de Laval, Canada
3Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Canada
4Équipe de recherche en soins de première ligne, Centre de santé et de services sociaux de Laval, Canada
5Department of Medicine, Université de Montréal, Canada
6Department of Anesthesiology, Faculty of Medicine, Université de Montréal, Canada
7Institut universitaire de gériatrie de Montréal, Department of Medicine, Université de Montréal, Canada
8Division of Geriatric Medicine, McGill University Health Centre, Department of Medicine, McGill University, Canada
9Ordre des pharmaciens du Québec, Montreal, Canada
10Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
11Sanofi Aventis Endowment Chair in Drug Utilization, Faculty of Pharmacy, Université de Montréal, Montreal, Quebec, Canada

Copyright © 2014 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Primary care providers’ knowledge, attitudes and beliefs (KAB) regarding chronic noncancer pain (CNCP) are a barrier to optimal management.

OBJECTIVES: To evaluate and identify the determinants of the KAB of primary care physicians and pharmacists, and to document clinician preferences regarding the content and format of a continuing education program (CEP).

METHOD: Physicians and pharmacists of 486 CNCP patients participated. Physicians completed the original version of the KnowPain-50 questionnaire. Pharmacists completed a modified version. A multivariate linear regression model was developed to identify the determinants of their KAB.

RESULTS: A total of 137 of 387 (35.4%) physicians and 110 of 278 (39.5%) pharmacists completed the survey. Compared with the physicians, the pharmacists surveyed included more women (64% versus 38%) and had less clinical experience (15 years versus 26 years). The mean KnowPain-50 score was 69.3% (95% CI 68.0% to 70.5%) for physicians and 63.8% (95% CI 62.5% to 65.1%) for pharmacists. Low scores were observed on all aspects of pain management: initial assessment (physicians, 68.3%; pharmacists, 65.4%); definition of treatment goals and expectations (76.1%; 61.6%); development of a treatment plan (66.4%; 59.0%); and reassessment and management of longitudinal care (64.3%; 53.1%). Ten hours of reported CEP sessions increased the KAB score by 0.3 points. All clinicians considered a CEP for CNCP to be essential. Physicians preferred an interactive format, while pharmacists had no clear preferences.

CONCLUSION: A CEP to improve primary care providers’ knowledge and competency in managing CNCP, and to reduce false beliefs and inappropriate attitudes regarding CNCP is relevant and perceived as necessary by clinicians.