S. Deslauriers1,2, J.-S. Roy1,2, S. Bernatsky3,4,5, N. Blanchard1,2, D. E. Feldman6,7,8, A.M. Pinard1,2,9, M.-A. Fitzcharles3,4, F. Desmeules6,10, K. Perreault1,2
1Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Canada, 2Université Laval, Quebec, Canada, 3McGill University Health Centre, Montreal, Canada, 4McGill University, Montreal, Canada, 5Research Institute of the McGill University Health Centre, Montreal, Canada, 6Université de Montréal, Montreal, Canada, 7Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada, 8Public Health Research Institute of Université de Montréal, Montreal, Canada, 9Centre Hospitalier Universitaire (CHU) de Québec, Quebec, Canada, 10Maisonneuve-Rosemont Hospital (CRHMR) Research Center, Montreal, Canada
Background: Extensive waiting times before receiving services have been identified as a major barrier to adequate pain management. Waiting times may have a detrimental impact on clinical outcomes such as quality of life. However, there remains a lack of knowledge on the lived experiences of patients waiting to receive services, especially for those with rheumatic conditions.
Purpose: The primary aim of the present study was to gain an in-depth understanding of perceptions and experiences of patients with rheumatic conditions regarding access to pain clinic services. The secondary aim was to identify possible solutions to improve this access according to patients’ perspectives.
Methods: For this qualitative study, semi-structured interviews were carried out with adults with rheumatic conditions waiting to access pain clinics in the province of Quebec, Canada. Interviews were transcribed verbatim and then analyzed using thematic content analysis.
Results: Twenty-six persons participated in the interviews (22 women, 4 men; mean age 54 ± 10 years). Four main themes emerged from the data: 1) the perception that waiting time was unacceptably long; 2) how lack of information affects patients’ experiences of waiting; 3) patients’ expectations towards the pain clinic are heterogeneous, from high hopes to disillusionment and 4) waiting is associated with an emotional, physical and financial burden. Participants reported several strategies to improve the experience of waiting, such as providing information to patients, increasing resources, optimizing prioritization processes and care coordination, and offering alternative interventions to patients during the wait.
Conclusion(s): Access to pain clinic services is challenging for patients with rheumatic conditions, due to extensive waiting times. The burden this wait imposes adds to the existing challenge of living with a chronic rheumatic condition. The strategies identified by the participants serve as building blocks to develop and implement measures to improve the overall experience of accessing pain-related services.
Implications: This project sheds light on the lived experiences of patients before they start pain management services and identifies ways to help improve these experiences. Such results will thus support physiotherapists in their professional roles, as they are often part of the clinical and managerial teams in pain clinics.
Funding, acknowledgements: This research was supported by the Canadian Initiative for Outcomes in Rheumatology Care (CIORA) grant from the Canadian Rheumatology Association.
Keywords: Chronic pain, Waiting time, Rheumatic conditions
Topic: Pain & pain management
Did this work require ethics approval? Yes
Institution: CIUSSS de la Capitale-Nationale
Committee: Comité d’éthique de la recherche sectoriel en réadaptation et intégration sociale
Ethics number: MP-13-2016-557, RIS_EMP-2015-449
All authors, affiliations and abstracts have been published as submitted.
