Care Pathways in Persistent Orofacial Pain: Qualitative Evidence from the DEEP Study

Area of Science:

• Oral and Maxillofacial Surgery
• Pain Management
• Health Services Research

Background:

• Persistent orofacial pain significantly affects patient quality of life.
• Current care pathways for orofacial pain are suspected to be problematic but lack detailed patient-reported experience.
• Understanding patient journeys is crucial for identifying inefficiencies in care delivery.

Purpose of the Study:

• To explore the care pathways utilized by patients with persistent orofacial pain.
• To understand the impact of these care pathways from the patients' perspective.
• To identify specific challenges and experiences within the existing healthcare system.

Main Methods:

• Qualitative interviews were conducted with a diverse sample of patients receiving care in primary and secondary settings in the UK.
• A constant comparative method was used for data analysis, supported by NVivo 10 software.
• Twenty-two patients were interviewed initially, with 18 participating in a follow-up interview after 12 months.

Main Results:

• Patients described a "fluidity of the care pathway," frequently moving between providers without resolution.
• A "failure to progress" was evident, characterized by diagnostic delays and frustration with ineffective treatments.
• The "effects of unmanaged pain" were significant, with prolonged pain exacerbating negative life impacts.

Conclusions:

• The current care pathway for persistent orofacial pain is inefficient and inadequately meets patient needs.
• Significant delays in diagnosis, treatment, and referral were reported by patients.
• A patient-centered redesign of care pathways is essential to improve outcomes for individuals with persistent orofacial pain.