Two-question survey could help improve pain management, reduce opioid use

Editor's Note

A simple, two-question survey could help identify patients most likely to develop chronic pain during recovery from surgery or injury and direct them toward proactive, holistic services that reduce reliance on opioids. NEJM Catalyst published the findings on March 20.

Conducted by a research team from Duke University, the study involved administering the survey to patients referred to Duke’s pain and wellness program. The two questions are: “1) Have you ever felt your pain is terrible and it's never going to get any better? (Y/N) 2) Have you ever used an illegal drug or prescription medication for non-medical reasons? (Y/N).”

Of all surveyed patients, 12%—more than 13,500 total—responded yes to both questions and were identified as being at high risk of poor pain outcomes. These high-risk patients were further grouped into low, medium and high-risk groups and offered personalized treatment plans that included support from a pain specialist, connection to social services, and access to behavioral health, physical therapy and nutrition resources. 

Thanks to the interventions provided, 51% of the highest risk patients (or 224) reduced their morphine dose within 30 days. The numbers rose to 299 patients at 60 days and 349 patients at 180 days. 

Ultimately, the approach yielded better results than traditional methods and could pave the way for more preventative and personalized approaches to pain management to drive better patient outcomes, including less reliance on opioids, the researchers write.