The impact of communication on adherence in pain management.

Despite a high prevalence of pain and ongoing effort to understand and reduce pain, studies show that there remains a considerable unmet need for pain relief and management. In part, this may be due to patient's not adhering to treatment recommendations. Models such the health belief model, self-regulation theory, and the theory of planned behavior suggest two key factors in promoting adherence: (1) good health care provider-patient communication and (2) interventions that are tailored to individuals' reasons for non-adherence. Hence, communication skills that express a nonjudgmental approach, allow open exploration of patient beliefs and concerns, and use a negotiating approach that fosters shared decision making are crucial. Randomized, controlled trials of brief communication skills training have shown improved outcomes in primary care settings for patients with fibromyalgia and acute pain. Thus, although treatment of chronic pain is challenging, good communication between health providers and patients can promote adherence and improve outcomes.