Knowledge and attitudes survey in bleeding disorders providers regarding pain

Introduction: The National Pain Study identified respondents (39%) were not satisfied with their pain management yet over 50% seek out their Haemophilia Treatment Centre (HTC) providers for pain management. This study's purpose was to assess the knowledge and attitudes of HTC providers regarding pain assessment and treatment.

Methods: One hundred and fifty-two HTC providers responded to a Survey Monkey™ Questionnaire.

Results: Knowledge deficits noted in pharmacology included (i) potentiators of opioids, (ii) time to peak effect of oral morphine, (iii) benzodiazepines usage as effective pain relievers and (iv) dose escalation/respiratory depression in an opioid tolerant patient. Areas of deficit in the substance abuse category involved (i) likelihood of a previous alcohol/drug abuse problem and (ii) signs and symptoms of discontinuation syndrome. Despite 100% confirmation from all providers that the patient is the best source of pain reporting, when presented with two identical case scenarios except for the patient's visual pain presentation; pain ratings were reported differently for patients who rated their pain similarly (8/10), yet displayed their pain symptoms differently resulting in different pain medication regimens. Responses were consistent between the provider groups but varied between case studies suggesting disparity between personal attitudes of providers when prescribing pain medication in the haemophilia population.

Conclusions: Continued research in the area of haemophilia pain as well as treatment is needed. In addition, continuing pain education is recommended for HTC provider's at the local, regional and national levels so providers could remain up to date in the changes and progress of pain management theory.