• Curtis May, Sandra Peterson, Ellie Gooderham, Lindsay Hedden, Rita K McCracken, and M Ruth Lavergne.
• Family physician and public health and preventive medicine resident at the University of British Columbia in Vancouver.
• Can Fam Physician. 2024 Sep 1; 70 (9): 570579570-579.

ObjectiveTo examine trends in chronic pain (CP) practice patterns among community-based family physicians (FPs).DesignPopulation-based descriptive study using health administrative data.SettingBritish Columbia from fiscal years 2008-2009 to 2017-2018.ParticipantsPatients with an algorithm-defined CP condition and community-based FPs, both registered with the British Columbia Medical Services Plan.Main Outcome MeasuresUsing British Columbia health administrative data and a CP algorithm adapted from a previous study, the following were compared between fiscal years 2008-2009 and 2017-2018: CP patient volumes, pain-related medication prescriptions, referrals to pain specialists, musculoskeletal imaging requests, and interventional procedures.ResultsIn the fiscal year 2017-2018, among community-based family physicians (N=4796), an average of 32.5% of their patients had CP. Between 2008-2009 and 2017-2018, the proportion of CP patients per FP who were prescribed long-term opioids increased by an average absolute change of 0.56%; the proportion prescribed long-term neuropathic pain medications increased by 1.1%; and the proportion prescribed long-term nonsteroidal anti-inflammatory drugs decreased by 0.49%. The proportion of musculoskeletal imaging out of all imaging requests made by FPs increased by 2.0%; pain-related referrals increased by 1.73%; there was a 4.6% increase in the proportion of community-based FPs who performed 1 or more pain injections; and 10% more FPs performed 1 or more trigger point injections within a fiscal year.ConclusionFindings show that the work of providing care to patients with CP increased while CP patient volumes per FP decreased. Workforce planning for community-based FPs should consider these increased demands and ensure FPs are adequately supported to provide CP care.Copyright © 2024 the College of Family Physicians of Canada.

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