Chronic Pain and Distress in the Primary Care Setting: Implementing a Digital Pain and Distress Screener to Optimize Integrated Psychological Treatment.

Chronic pain is common, complex, undertreated, and linked with lower quality of life. The primary care setting provides an opportunity to standardize screening for chronic pain and distress and facilitate early intervention via integrated psychological treatment. This study describes the use of a digital pain and distress screener to improve identification of those who could benefit from integrated psychological treatment to manage chronic pain in primary care. An electronic pain and distress screening tool was implemented in an academic internal medicine clinic at an urban hospital. Data regarding screening completion, percentage of positive screens, and number of integrated psychology referrals were pulled from the electronic medical record. 1,676 unique pain and distress screenings were completed between March 2024 and January 2025. Forty-three percent of patients screened positive (n = 837). Thirty-nine patients were referred for integrated psychological treatment and 20 completed at least one visit. Older adult patients completed the digital pain and distress screener at similar rates to other digital screenings with positive screening rates similar to the known prevalence of comorbid pain and distress. Referral rates were low though a high proportion of referrals began treatment. With modifications to workflow, the pain and distress screening could facilitate early and effective intervention.