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RESEARCH PRODUCT

Prevalence of Burnout Among Pain Medicine Physicians and Its Potential Effect upon Clinical Outcomes in Patients with Oncologic Pain or Chronic Pain of Nononcologic Origin

José-ignacio ChacónJosé-francisco SorianoVicente MonsalveSusana TraseiraAlba-violeta GándaraInmaculada MuroIrene Riquelme

subject

AdultMalemedicine.medical_specialtyAdolescentPain medicineBurnout PsychologicalBurnout03 medical and health sciences0302 clinical medicineQuality of lifePhysiciansSurveys and QuestionnairesPrevalencemedicineHumansProspective Studies030212 general & internal medicineProspective cohort studyBurnout ProfessionalAgedbusiness.industryChronic painCancer PainGeneral MedicineOdds ratioMiddle Agedmedicine.diseaseConfidence intervalAnesthesiology and Pain MedicinePhysical therapyFemaleObservational studyNeurology (clinical)Chronic Painbusiness030217 neurology & neurosurgery

description

Objective To evaluate the prevalence of burnout among physicians treating patients with chronic pain and to assess the potential relationships between the presence of burnout and patients' clinical outcomes such as pain relief, satisfaction with pain control, and quality of life. Design An observational, prospective, and noncomparative study. Setting Pain medicine clinics. Subjects Physicians from medical departments involved in the management of chronic pain. Patients aged ≥18 years who exhibited moderate chronic pain lasting at least three months. Methods Physicians were evaluated with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Patients were evaluated with the Charlson Comorbidity Index, the Brief Pain Inventory-Short Form (BPI-SF), the EuroQol-5D (EQ-5D), and ad hoc instruments for evaluating satisfaction with pain control, the extent to which the treatment met patients' expectations, and subjective impressions of improvement. Results Of the 301 physician participants, 22 (7.3%, 95% confidence interval [CI] = 4.9 to 10.8) met the criteria of burnout. Burnout was higher among physicians from pain units, while none of the 35 primary care physicians reported burnout. The presence of burnout was positively associated with patients' pain relief (odds ratio [OR] = 1.423, 95% CI = 1.090 to 1.858) but not with satisfaction with pain control or quality of life. Of the remaining independent variables, being treated by pain unit physicians was significantly associated with worse pain relief (OR = 0.592, 95% CI = 0.507 to 0.691), lower satisfaction (β = -0.680, 95% CI = -0.834 to -0.525), and worse quality of life (β = -4.047, 95% CI = -5.509 to -2.585) compared with being treated by physicians from other specialties (e.g., traumatologists, oncologists, etc.). Conclusions Our study shows a lack of negative or clinically relevant (as shown by the negligible to small effect sizes) impact of burnout on patient-reported outcomes (namely, pain relief, satisfaction, and quality of life) in patients with chronic pain who are treated by pain medicine physicians.

https://doi.org/10.1093/pm/pnx335