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Utilization and Patients’ Perceptions of the Effectiveness of Pain Treatments in Multiple Sclerosis: A Cross-sectional Survey
Dawn M. Ehde, Ph.D., Kevin N. Alschuler, Ph.D., Travis L. Osborne, Ph.D., Marisol A. Hanley, Ph.D., Mark P. Jensen, Ph.D., George H. Kraft, M.D.
Although chronic pain is common among persons with multiple sclerosis (MS), little is known about the utilization and patients’ perception of the effectiveness of pain treatments in MS.
The objectives were to: (1) identify specific treatments currently used for pain relief by adults with MS; (2) examine patients’ perceptions of the effectiveness of each of these treatments; and (3) examine rates of health care utilization, specifically provider and emergency department visits, for pain.
One hundred twenty-five community dwelling participants with MS and pain completed a postal survey that measured demographics, MS disease, pain, pain treatments, perceived effectiveness of treatments, and healthcare utilization.
The majority (89.6%) of the sample reported use of a variety of and multiple pain treatments (range = 1-19, median = 9.0, mean = 9.0, SD = 4.2); few were rated as providing pain relief. Non-prescription pain relievers were the most commonly reported treatment. Physical treatment modalities were also common. The treatments that were reported by patients to provide the greatest pain relief, such as hypnosis, nerve blocks, and marijuana, were not those that were the most frequently used. Overall, 75% reported at least one visit to a provider for pain in the past six months; participants made, on average, 9.7 visits for pain during this same time period. Emergency department visits explicitly for pain were reported by 11% of respondents.
These findings suggest that pain is inadequately treated from the perspective of persons with MS and results in a high level of health care utilization.