MICHIGAN DEPARTMENT OF COMMUNITY HEALTH

PAIN MANAGEMENT SURVEY

1000 Sample

March 4, 2011

TABLE OF CONTENTS

Page Topic

3 Methodology

4 Key Findings

7 Aggregate Survey Results

20 Cross-tabulation Report

60 Appendix A: Question 20/ Open Responses

61 Appendix B: Question 18/ Open Responses

62 Appendix C: Question 19/ Open Responses

METHODOLOGY

The Glengariff Group, Inc. conducted a 1,000 sample statewide, random digit dial survey of Michigan residents for the Michigan Department of Community Health. The survey has a margin of error of +/-3.1% with a confidence level of 95%. The survey was conducted on March 1-3, 2011. This survey reflects an identical survey conducted in March 2009.

The left column provides aggregate responses from the March 2009 survey. The right column provides aggregate responses from the March 2011 survey.

KEY FINDINGS

·  28.0% of Michigan residents have been told that they are entitled to have their pain managed as a basic part of their health care representing a slight increase from 24.3% in March 2009.

§  In the 2009 survey there was a statistically significant difference among Caucasian and African American respondents: 25.3% of Caucasian respondents had been told they are entitled to have their pain managed as compared to only 17.6% of African American respondents. But that gap narrowed in the most recent 2011 survey with 27.9% of Caucasian respondents being told they could have their pain managed and 23.4% of African American respondents being told they could have their pain managed.

·  91.9% of respondents agree that acute pain can be effectively managed with today’s pain medications or other treatments. Statistically unchanged from 89.0% in 2009. But 64.4% strongly agree with this statement in 2011 as compared to 50.8% of respondents that strongly agreed in 2009. 64.3% of respondents agree that chronic pain can be effectively managed with medications or treatments – unchanged from 63.3% in 2009 -- and only 27.7% of respondents strongly agree, an increased from 21.3% in 2009.

·  By a margin of 64.9%-28.9% respondents agree that people do not seek pain treatment because they fear becoming addicted to pain medication. In 2009 the margin was 60.7%-30.5%.

·  29.0% of Michigan residents have sought treatment from a health care professional for an acute pain condition in the past year, statistically unchanged from 28.2% who received treatment in the 2009 survey. Respondents report a pain level of 7.30 prior to seeking treatment and a pain level of 3.00 after seeking treatment. In 2009, respondents reported a pain level of 7.02 prior to seeking treatment and a pain level of 2.75 after seeking treatment.

§  30.0% of respondents with insurance reported seeking acute pain treatment while only 22.0% of respondents without insurance reported seeking acute pain treatment. These figures are statistically consistent with the 2009 survey when 29.0% of insured respondents sought treatment and 20.6% of uninsured respondents sought treatment.

·  27.2% of Michigan residents have sought treatment from a health care professional for a chronic pain condition in the past year as compared to 24.3% in 2009. Respondents reported a pain level of 7.60 prior to seeking treatment and a pain level of 4.00 after seeking treatment. In 2009, respondents reported a pain level of 7.47 before seeking treatment and a pain level of 3.67 after seeking treatment. In 2011, respondents with chronic pain conditions report their current pain level at 4.70 – a statistically significant increase from 4.22 in 2009.

§  Residents that were most likely to seek treatment for chronic pain were respondents over the age of 45 years old and respondents with income levels below $70,000.

§  Female respondents, respondents with income levels below $70,000, and respondents with no insurance reported the highest levels of pain prior to seeking treatment for a chronic condition.

§  By a margin of 75.0%-20.2%, respondents with a chronic pain condition are satisfied with the treatment they did or are receiving for their condition statistically unchanged from 77.0%-16.1% in the 2009 survey.

·  Respondents were asked over the past year if they had received pain treatment from a list of health care professionals. The results remain consistent with the 2009 survey findings. (2009 results are in parenthesis.)

§  50.0% (54.8%) had received care from a primary care provider, general practice doctor, osteopathic nurse, nurse practitioner or physician’s assistant.

§  14.6% (14.4%) received care from a physical therapist.

§  13.0% (14.2%) received care from a chiropractor.

§  11.8% (13.1%) received care from an orthopedic physician.

§  12.8% (11.0%) received care from a surgeon.

§  7.4% (8.6%) received care from a massage therapist.

·  6.9% of respondents indicated that they had ever had a physician or health care provider show a reluctance or refusal to prescribe what the respondents thought was an effective type or amount of pain medication. This figure is within the margin of error of the 2009 survey that showed 4.5%.

·  24.5% of respondents have had an acute or chronic pain condition for which they did not seek medical treatment, statistically unchanged from 23.8% in the 2009 survey. Respondents most likely not to seek treatment had no insurance and earned less than $25,000 annually.

·  In the past year, 18.1% of respondents have had an acute or chronic pain condition which prevented them from either going to work or doing their job while at work statistically unchanged from 16.9% in 2009.

MDCH PAIN MANAGEMENT SURVEY

Hello, my name is ______. I’m not selling anything. I am doing a survey of Michigan residents studying the issue of pain management for the Michigan Department of Community Health. The information from this survey will help to guide the state’s policy on pain management issues. The survey should take less than ten minutes.

For statistical purposes, can you tell me in which year you were born? IF LESS THAN 18, ASK: IS THERE ANYONE IN THE HOUSEHOLD OVER 18 YEARS OLD WITH WHOM I CAN SPEAK?

1. Age

2009 2011

1. 18-24 (1985-1991) 4.3% 5.0%

2. 25-34 (1975-1984) 8.2% 10.7%

3. 35-44 (1965-1974) 20.9% 24.1%

4. 45-54 (1955-1964) 26.2% 21.0%

5. 55-64 (1945-1954) 20.2% 19.2%

6. 65 + (1944 or before) 20.2% 20.0%

7. Refused/ don’t know…TERMINATE 0.0% 0.0%

2. In what county do you live? IF WAYNE, ASK: WOULD THAT BE IN THE CITY OF DETROIT OR OUTSIDE OF THE CITY OF DETROIT?

2009 2011

  1. Northern Michigan 13.0% 13.0%
  2. West Michigan 11.0% 11.0%
  3. Southwest Michigan 8.5% 8.5%
  4. Mid Michigan 8.6% 8.6%
  5. Tri Cities/ East Central 7.9% 7.9%
  6. Oakland County 13.4% 13.4%
  7. Macomb County 8.4% 8.4%
  8. Wayne County 11.1% 11.1%
  9. City of Detroit 7.0% 7.0%
  10. Remainder of Detroit MSA 11.1% 11.1%
  11. Refused….TERMINATE 0.0% 0.0%

3. Have you ever heard or been told that as a Michigan resident or patient you are entitled to have your pain managed as a basic part of your health care?

2009 2011

  1. Yes, have been told 24.3% 28.0%
  2. No, have not been told 74.6% 69.7%
  3. Don’t know/ cannot recall 1.0% 2.3%
  4. Refused…DO NOT OFFER 0.1% 0.0%

When people talk about pain, they are talking about two different types of pain: acute and chronic. Acute pain refers to a pain that is generally temporary and short-lived such as a toothache, a strained muscle, an injury, or the pain following surgery. Chronic pain, on the other hand, tends to be continuous and recurring and may be caused by illnesses or ongoing conditions such as arthritis, cancer, fibromyalgia, or a number of other on-going health problems.

4. Based on what you know about acute pain – which is a short lived pain –would you say you agree or disagree with the following statement: “Acute pain can be effectively managed with today’s pain medication or other treatments.” ASK: WOULD THAT BE STRONGLY AGREE/DISAGREE OR JUST SOMEWHAT AGREE/DISAGREE?

2009 2011

  1. Strongly agree 50.8% 64.4%
  2. Somewhat agree 37.2% 27.5%
  3. Somewhat disagree 4.1% 2.0%
  4. Strongly disagree 4.4% 2.3%
  5. Neither agree, nor disagree….DO NOT OFFER 1.4% 1.0%
  6. Don’t know…DO NOT OFFER 1.8% 2.8%
  7. Refused…DO NOT OFFER 0.3% 0.0%

5. Based on what you know about chronic pain – which is a continuous pain – would you say you agree or disagree with the following statement: Chronic pain can be effectively managed with today’s pain medication or other treatments.

ASK: WOULD THAT BE STRONGLY AGREE/DISAGREE OR JUST SOMEWHAT AGREE/DISAGREE?

2009 2011

1.  Strongly agree 21.3% 27.7%

2.  Somewhat agree 42.0% 36.6%

3.  Somewhat disagree 15.0% 13.0%

4.  Strongly disagree 12.3% 10.2%

5.  Neither agree, nor disagree…DO NOT OFFER 2.9% 3.5%

6.  Don’t know…DO NOT OFFER 6.4% 8.9%

7.  Refused…DO NOT OFFER 0.1% 0.1%

6. Please tell me whether you agree or disagree with the following statement. “People do not seek treatment for pain because they fear becoming addicted to pain medications.” Would you say you agree or disagree with that statement? ASK: WOULD THAT BE STRONGLY AGREE/DISAGREE OR JUST SOMEWHAT AGREE/DISAGREE?

2009 2011

  1. Strongly agree 22.1% 30.4%
  2. Somewhat agree 38.6% 34.5%
  3. Somewhat disagree 16.3% 11.2%
  4. Strongly disagree 14.2% 17.7%
  5. Neither agree, nor disagree…DO NOT OFFER 5.4% 2.9%
  6. Don’t know…DO NOT OFFER 3.4% 3.2%
  7. Refused…DO NOT OFFER 0.0% 0.1%

7. Again, acute pain refers to a temporary or short term condition such as a toothache, strained muscle, an injury, or pain following surgery. In the past year, have you sought treatment from a health care professional for an acute pain condition?

2009 2011

  1. Yes…MOVE TO Q8 28.2% 29.0%
  2. No….MOVE TO Q11 71.7% 70.8%
  3. Don’t know/ can’t remember…DO NOT OFFER/ MOVE TO Q11 0.1% 0.1%
  4. Refused…DO NOT OFFER/ MOVE TO Q11 0.0% 0.1%

8. On a scale from one to ten, with one meaning ‘zero pain’ and 10 meaning ‘the worst pain you could experience’, on most days how would you have rated your pain level BEFORE you were treated for your acute pain condition?

MEAN SCORE: 7.02 7.30

1 2 3 4 5 6 7 8 9 10 DK/Ref

1.8% 2.1% 3.2% 6.0% 12.4% 11.0% 14.5% 22.0% 11.0% 15.2% 0.7%

0.3% 2.4% 3.1% 4.5% 8.6% 13.8% 13.8% 21.4% 9.0% 22.1% 1.0%

9. And on that same scale of one to ten, with one meaning ‘zero pain’ and ten meaning ‘the worst pain you could experience’, on most days how would you rate your pain level AFTER you were treated for your acute pain condition?

MEAN SCORE: 2.75 3.00

1 2 3 4 5 6 7 8 9 10 DK/Ref

33.7% 21.3% 16.0% 12.1% 6.0% 2.5% 3.9% 1.1% 1.1% 0.7% 1.8%

35.9% 16.2% 13.4% 9.0% 10.3% 3.4% 3.8% 3.4% 1.7% 1.0% 1.7%

10. To what degree are you satisfied or not satisfied with the treatment you received for your acute pain condition? Would you say that you were very satisfied, somewhat satisfied, somewhat unsatisfied or very unsatisfied?

2009 2011

  1. Very satisfied 54.6% 55.7%
  2. Somewhat satisfied 31.6% 29.7%
  3. Neither satisfied/nor dissatisfied…DO NOT OFFER 2.5% 1.4%
  4. Somewhat unsatisfied 6.0% 6.6%
  5. Very unsatisfied 5.3% 5.2%
  6. Don’t know/ refused….DO NOT OFFER 0.0% 1.4%

11. As you recall, chronic pain tends to be recurring pain caused by illness or conditions such as arthritis, cancer, fibromyalgia, or other ongoing health problems. In the past year, have you ever received treatment to manage a chronic pain condition?

2009 2011

  1. Yes…MOVE TO Q12 24.3% 27.2%
  2. No…MOVE TO Q16 75.6% 72.7%
  3. Don’t know/ can’t remember…DO NOT OFFER/ MOVE TO Q16 0.0% 0.0%
  4. Refused….DO NOT OFFER/MOVE TO Q16 0.1% 0.1%

12. On a scale from one to ten, with one meaning ‘zero pain’ and 10 meaning ‘the worst pain you could experience’, on most days how would you rate your pain level BEFORE you were treated for your chronic pain condition?

MEAN SCORE: 7.47 7.60

1 2 3 4 5 6 7 8 9 10 DK/Ref

0.4% 1.6% 3.3% 2.5% 8.6% 9.5% 16.0% 27.2% 9.9% 18.9% 2.1%

0.4% 0.4% 4.0% 3.7% 6.6% 12.9% 11.4% 24.3% 12.5% 23.2% 0.7%

13. And on that same scale of one to ten, with one meaning ‘zero pain’ and ten meaning ‘the worst pain you could experience’, on most days how would you rate your pain level AFTER you were treated for your chronic pain condition?

MEAN SCORE: 3.67 4.00

1 2 3 4 5 6 7 8 9 10 DK/Ref

16.9% 19.3% 16.5% 13.2% 12.8% 6.2% 7.0% 4.5% 0.4% 1.2% 2.1%

147% 15.4% 15.4% 18.0% 11.0% 5.9% 6.3% 5.1% 1.8% 3.3% 2.9%

14. And using that same one to ten scale, during the last two weeks how would you rate your pain level for your chronic pain condition?

MEAN SCORE: 4.22 4.70

1 2 3 4 5 6 7 8 9 10 DK/Ref

17.7% 12.3% 15.2% 11.5% 9.5% 10.3% 6.2% 9.9% 2.9% 2.1% 2.5%

16.2% 11.4% 11.0% 10.7% 13.2% 9.2% 8.8% 9.6% 4.0% 5.5% 0.4%

15. To what degree are you satisfied or not satisfied with the treatment you are receiving or did receive for your chronic pain condition? Would you say that you were very satisfied, somewhat satisfied, somewhat unsatisfied or very unsatisfied?

2009 2011

  1. Very satisfied 35.0% 37.1%
  2. Somewhat satisfied 42.0% 37.9%
  3. Neither satisfied/nor dissatisfied…DO NOT OFFER 2.9% 1.8%
  4. Somewhat unsatisfied 13.2% 10.3%
  5. Very unsatisfied 7.0% 9.9%
  6. Don’t know/ refused….DO NOT OFFER 0.0% 2.9%

16. I am going to read you a list of health care professionals who may have treated your pain over the past year. For each type of professional, please tell me if you have sought help from this type of health care professional at any point during the last year. READ OPTIONS 1-18

2009 2011

  1. Acupuncturist 1.5% 0.6%
  2. Chiropractor 14.2% 13.0%
  3. Massage therapist 8.6% 7.4%
  4. Oncologist or cancer specialist 2.8% 3.9%
  5. Orthopedic physician 13.1% 11.8%
  6. Osteopathic physician for manipulation 4.3% 4.0%
  7. Pain specialist 6.8% 8.9%
  8. Palliative care or hospice specialist 0.2% 0.2%
  9. Physical therapist 14.4% 14.6%
  10. A Primary care provider such as a family doctor, a general practice doctor, an osteopathic nurse, a nurse practitioner, or a physician’s assistant. 54.8% 50.0%
  11. Psychiatrist 3.9% 2.7%
  12. Psychologist, social worker, or a mental health counselor 4.0% 2.6%
  13. Rheumatologist 3.8% 4.9%
  14. Spiritual counselor or a member of the clergy 5.3% 4.0%
  15. Sports medicine physician 2.6% 2.7%
  16. Surgeon 11.0% 12.8%
  17. Was there anyone else who treated you? SEE APPENDIX A 7.2% 6.1%
  18. I HAVE NOT BEEN TREATED FOR PAIN THE PAST YEAR/ 33.0% 42.1%

[MOVE TO Q19]