Pain Medication Beliefs Can Enhance (or Impair) Pain Relief Interview with:
Leon Timmerman, PhD
St Antonius Hospital, Department of Anesthesiology
Intensive Care and Pain Medicine
The Netherlands

Leon Timmerman, PhD St Antonius Hospital, Department of Anesthesiology Intensive Care and Pain Medicine The Netherlands
Dr. Timmerman  What is the background for this study?  What are the main findings?

Response: Chronic pain is commonly treated with pain medication. However, the results of pharmacological treatment are often poor. One of the reasons might be that half of the patients do not use their medication as prescribed. Underuse as well as overuse are common and have been described to result in reduced treatment effect, health care risks and unnecessary treatment changes. The are many risks factors described for non-adherent behavior.

The way people think about their pain medication have been shown to be related to the way they use their medication. With this study, we confirmed this relation with a prospective study. Baseline beliefs about pain medication, measured by ‘Pain Medication Attitudes Questionnaire’,  were found to be related to underuse of pain medication, the occurrence of side effects and patient satisfaction after three months. What should readers take away from your report?

Response: Readers should be aware that negative beliefs about pain medication may impair treatment results, possibly due to nocebo mechanisms. Taking these beliefs into account should be part of the prescription process. Management of expectations might be a way to optimize pharmacological treatment effects. What recommendations do you have for future research as a result of this work?

Response: Other studies (e.g. in cardiac surgery) demonstrate surprising effects of expectation managing interventions on outcome parameters. Future research should investigate the effects of clinical interventions that address and improve individual patient beliefs and expectations about pain medication on medication adherence behavior and treatment outcome parameters.

I do not have any disclosures.


The Relation between Patients’ Beliefs about Pain Medication, Medication Adherence and Treatment Outcome in Chronic Pain PatientsA Prospective Study
Timmerman, Leon PhD*; Stronks, Dirk L. PhD; Huygen, Frank J. PhD

The Clinical Journal of Pain: September 10, 2019 – Volume Publish Ahead of Print – Issue –
doi: 10.1097/AJP.0000000000000760