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Copyright © 2019 S. Fatima Lakha et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. http://creativecommons.org/licenses/by/4.0/

Abstract

An increasing proportion of the global chronic pain population is managed through services delivered by specialized pain clinics in global cities. This paper describes the results of a survey of pain clinic leaders in three global cities on barriers influencing chronic noncancer pain (CNCP) management provided by those clinics. It demonstrates a pragmatic qualitative approach for characterizing how the global city location of the clinic influences those results. A cross-sectional prospective survey design was used, and data were analyzed using quantitative and qualitative content analysis. Key informants were pain clinicians (n = 4 women and 8 men) responsible for outputs of specialized pain clinics in academic hospital settings in three global cities: Toronto, Kuwait, and Karachi. Krippendorff’s thematic clustering technique was used to identify the repetitive themes in the data. All but one of the key informants had their primary pain training from Europe or North America. In Kuwait and Karachi, pain specialists were anesthesiologists and provided CNCP management services independently. In Toronto, pain clinic leaders were part of some form of the multidisciplinary team. Using the results of a question that asked informants to list their top three barriers, ten themes were identified. These themes were artificially organized in three thematic domains: infrastructure, clinical services, and education. In parallel, 31 predefined barriers identified from the literature were scored. The results showed variation in perception of barriers that not only depended on the clinic location but also demonstrated shared experiences across thematic domains. This study demonstrates a simple methodology for informing global and local efforts to improve access to and implementation of CNCP services globally.

Details

Title
Perspective of Pain Clinicians in Three Global Cities on Local Barriers to Providing Care for Chronic Noncancer Pain Patients
Author
S Fatima Lakha 1   VIAFID ORCID Logo  ; Ballantyne, Peri 2 ; Badr, Hanan 3 ; Agboatwala, Mubina 4 ; Mailis, Angela 5   VIAFID ORCID Logo  ; Pennefather, Peter 6   VIAFID ORCID Logo 

 Institute of Medical Science, University of Toronto, Toronto, Canada 
 Department of Sociology, Trent University, Faculty of Medicine, Peterborough, Canada 
 Department of Community Medicine, Kuwait University, Kuwait, Kuwait 
 HOPE, Karachi, Pakistan 
 Institute of Medical Science, University of Toronto, Toronto, Canada; Pain & Wellness Centre, Vaughan, Canada 
 Institute of Medical Science, University of Toronto, Toronto, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada 
Editor
Parisa Gazerani
Publication year
2019
Publication date
2019
Publisher
John Wiley & Sons, Inc.
ISSN
12036765
e-ISSN
19181523
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2182522535
Copyright
Copyright © 2019 S. Fatima Lakha et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. http://creativecommons.org/licenses/by/4.0/