Table 1.

How can the Influencing Factors Identified in this Study Inform Practice Innovations? Key Insights and Potential Practice Innovations Inspired by the Themes that Emerged in our Analysis of Factors that Influenced Changes to Chronic Pain Management Plans Based on Interviews with Primary care Clinicians from 2016 to 2018

Influencing FactorKey InsightPotential Practice Innovations
Change in patient conditionNew observations about patients, such as depression symptoms, and recent falls can prompt changes to chronic pain management.Innovations that monitor symptoms, contraindications, and other patient factors with the aim to support PCCs in recognizing when a change in pain management may be warranted.
Outcomes related to treatmentUnderstanding treatment effectiveness is a critical factor in chronic pain management.Innovations that assist PCCs in tracking the effectiveness of treatments over time (e.g., displays that correlate pain outcomes with prescribed treatments), including improved definitions and measures of effectiveness.
Non-adherent patient behavior & Approaches to new patientsCommunication with patients is essential. Conversations can reveal non-adherent behavior. Upfront discussions about pain goals can set expectations for treatment.Innovations that collect and synthesize hard-to-find data (such as past treatments and rationale for discontinuation), so PCCs spend less time foraging for information and more time communicating and developing relationships with patients.
Insurance constraintsInsurance constraints serve as a decision-making factor in changing pain management plans. However, PCCs have little training, guidance, or support with this task.Innovations that provide PCCs with information about what treatments are approved, the cost, and other requirements such as prior authorizations before ordering.
Change in guidelines, laws, or policiesChanges in guidelines can lead to changes in pain management for individual patients.Innovations that facilitate accurate interpretation of clinical practice guidelines and help translate those guidelines to simple, actionable, point-of-care guidance.
Specialist recommendationsSpecialist input can influence pain management, although PCCs may not always agree with specialist recommendations.Innovations in collaboration that support PCCs in communicating with other team members and specialists.
  • PCCs, primary care clinicians.