Patients in pain.

Communication research on medical interaction has made inroads into how patients shape treatment outcomes as well as how physician presentation of treatment can shape patient acceptance or resistance. Pain is the number one reason patients visit primary care physicians. The overprescription of opioids for chronic pain remains a major public health problem in the US and constitutes a risk factor for opioid addiction. In this study, we investigated how primary care physicians communicate recommendations for alternatives to opioid treatments for patients with self-reported moderate to serious chronic musculoskeletal pain and examined the relationship between communication strategies and patient resistance to non-opioid treatment recommendations. We relied on a convenience sample of 35 video recorded visits in which musculoskeletal pain was reported as moderate to severe (or over 5 on the pain scale). Using a combined approach of abductive analysis, conversation analysis and descriptive statistics, we show that physicians are less likely to face patient resistance when they frame their non-opioid pain treatment recommendation as novel and present the treatment as concrete and tailored to the patient's problem.