Understanding General Practitioner and Patient Perceptions of Integrating Non-Pharmacological Interventions in Chronic Non-Cancer Pain Management – a Cross-Sectional Mixed-Methods Study in the RELIEF Project

Chronic non-cancer-related pain is an independent condition with a multi-causal genesis. Guide-lines highlight the need for holistic treatment based on the bio-psycho-social model. While pre-scribing medication is common, it remains unclear how and to what extent non-pharmacological interventions are considered and recommended in general practice pain management. The pro-ject RELIEF explored integration of non-pharmacological interventions in general practice in Germany from physician and patient perspectives. A mixed-methods study collected data with patients and general practitioners via semi-structured telephone interviews and self-developed questionnaires. Qualitative data were analyzed in a reflexive thematic analysis. Survey data were analyzed descriptively. N=383 questionnaires (n=131 General practitioners, n=252 patients) and n=61 interviews (n=21 General practitioners, n=40 patients) were analyzed. Patient and physician perceptions of inte-grating non-pharmacological interventions differed. Patients felt pharmacological therapy was recommended primarily, applied non-pharmacological interventions based on own initiative, and were aware of bio-psycho-social interrelations. Physicians perceived they often recom-mended physiotherapy and psychotherapy alongside analgesics, and asked about non-pharmacological interventions (79.4%), explained the bio-psycho-social chronic pain genesis (55.7%), and provided information on physical (48.9%) and social (35.9%) activity, relaxation techniques (42%), topical applications (31.9%), and support groups (25.2%). Integration of holistic pain management and communication between patients and GPs appear to need strengthening.