Pain science knowledge among healthcare professionals: A cross-sectional survey within the United States Department of Veterans Affairs

Abstract: Background: Pain complaints are one of the primary reasons that military veterans seek healthcare within the United States Veterans Health Administration (VHA). VHA providers therefore need to be able to appropriately identify and classify clinical pain presentations and provide evidence-based management strategies. Objective: The objective of this exploratory quality improvement (QI) project was to identify gaps in pain science knowledge across healthcare professionals who participate in the pharmacological and non-pharmacological management of pain within the United States VHA. Design: Cross-sectional survey. Results/findings: Healthcare providers (n = 311; 2 % response rate) representing 17 professions completed the survey. Significant between group difference was demonstrated by profession (H = 23.46; p < .001), and by provider age (H = 65.29; p < .001) in self-reported confidence measures and revised neurophysiology of pain (rNPQ) scores (p < .001). None of the professions reported confidence identifying/treating nociplastic pain and a single profession (pharmacists) reported confidence differentiating between pain phenotypes. Overall, the mean rNPQ score was 9.0 out of 12. Physical therapists (9.9) and psychologists (9.2) scored highest while nurse practitioners (7.3) and clinical social workers (7.6) scored lowest. Individuals 31–40 years old scored the highest (9.0) while individuals greater than 60 years old scored the lowest (7.2). Conclusion: Pain knowledge within the VHA varies by profession and age. Educational opportunities within the VHA should be catered towards professions likely to benefit the most, including non-physician primary care providers. Educational opportunities should focus on terminology, differentiating between pain phenotypes, and understanding nociplastic pain phenotypes.

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