Researchers say they have figured out how to help patients in chronic pain remember their doctor's orders.
While pained patients tend to forget traditional rote instructions, such as, "Take three pills twice a day," they can better recollect directions given in story form, such as, "Take the medication after taking your spouse to work," their study shows."Past studies have shown chronic pain interferes with rote memory for words but less so with integrative memory for conceptual ideas. We wanted to look further into these findings and see how they could help patients," head researcher Janice Livengood of the Vanderbilt University Pain Control Center in Nashville, Tenn., said in an interview.
In her survey of 28 patients with chronic pain and 28 painless subjects, Livengood found the former were significantly better able to remember the contents of a story than a list of randomized words. No such difference was uncovered in the group that suffered no pain.
"We found the patients were far less likely to remember, `Take the blue pill three times a day,' than, `Take the blue pill when your spouse leaves for work, after you watch your favorite soap opera and when your spouse returns from work,' " Livengood said at the annual meeting of the American Society of Anesthesiologists.
A major reason patients with chronic pain fail to improve is noncompliance with treatment instructions, "not because they don't want to but because the pain is getting most of their attention and they can't remember what they're supposed to do," she said.
While some doctors may say they have no time to personalize medical directives to an individual patient's life, such protocol may be both cost and time effective by curtailing or eliminating return visits. In addition, the instructions can be given by a nurse, Livengood said.
The original studies, conducted by Dr. Winston Parris, professor of anesthesia and director of the pain control center, included patients under anesthesia, not in pain.
"We were testing the anesthetic property of two drugs," Parris said in an interview.
"The patients listened to 20 words like care, dog, cat, etc., were given the drug and were asked to repeat the list at increasingly longer time intervals."
As an outgrowth of that research, scientists found "the biochemical basis for pain patients having a lousy memory may be the proximity of the memory center to the center of pain-producing compounds. The dysfunction of one may affect the other. That's what Janice (Livengood) tested," Parris said.
"An implication of the study is that health care providers may experience more effective compliance with treatment regimens if they converse with their patients about a typical day," Livengood said.