Assessing Practice Patterns and Influential Factors for Nurse Practitioners Who Manage Chronic Pain.

Journal Article (Journal Article)


Challenges exist in caring for chronic pain patients, such as preventing opioid-related adverse events, a lack of available non-pharmacologic alternatives, and limitations in prescriptive authority. Nurse practitioners are well-suited to manage chronic pain due to their holistic approach to care and growing numbers in primary care. Yet little is known about the chronic pain care given by NPs. As such, the purpose of this study was to understand the experiences of NPs who manage chronic pain, and to examine how these experiences impact NP prescribing patterns in chronic pain management.


We developed the 31-item NP Chronic Pain Prescribing Practices survey. We collected data from N = 128 NPs at the American Association of Nurse Practitioners (AANP) conference. Pearson chi-square and Fisher's exact tests were utilized for statistical analysis.


NPs reported high levels of agreement with nearly all the presented challenges. MSN-prepared NPs were more likely than DNP-prepared NPs to report difficulty in managing pain (x 2 = 4.2, p = .04). There were no differences in prescription of chronic pain therapies between NPs of varying practice authority statuses. NPs in specialty care settings were more likely to utilize opioids (x 2 = 13.6, p < .01), while primary care NPs were significantly more likely to use NSAIDs (x 2 = 13.5, p < .01) and Tylenol (x 2 = 3.9, p = .05).


Our findings demonstrate significant challenges NPs face in chronic pain management. More research is needed to better understand the complexities associated with chronic pain care given by NPs in order to effectively manage chronic pain while still preventing opioid-related adverse events.

Full Text

Duke Authors

Cited Authors

  • Nikpour, J; Broome, M; Silva, S

Published Date

  • June 2021

Published In

Volume / Issue

  • 22 / 3

Start / End Page

  • 312 - 318

PubMed ID

  • 33714701

Electronic International Standard Serial Number (EISSN)

  • 1532-8635

International Standard Serial Number (ISSN)

  • 1524-9042

Digital Object Identifier (DOI)

  • 10.1016/j.pmn.2021.01.001


  • eng