GPs' experience of managing chronic pain in a South Asian community--a qualitative study of the consultation process

Background. Chronic pain is one of the most common reasons for seeking primary care consultations.
GPs’ experience of managing patients with pain from a multicultural community
has not previously been examined.
Objectives. We explored GPs’ experiences of managing patients with chronic pain from a South
Asian community in Leicester.
Methods. Qualitative semi-structured interviews were conducted with GPs from practices in
two primary care trusts within Leicester. Eighteen GPs (11 males and 7 females) were interviewed
in this study.
Results. Several emerging themes were identified from the data including consulting behaviour,
presentation of pain, GPs personal challenges, psychosomatic interpretations and communication.
Overall, GPs find that managing South Asian patients with chronic pain can be
challenging as a consequence of the way in which patients present with pain. Difficulties for
GPs were created not only by language differences but also by cultural differences, which were
not seen in second or third generation South Asians. GPs felt that self-management was difficult
to address, and compliance with medication difficult to determine. In such consultations, GPs
perceived that patients were more likely to present with psychosomatic symptoms.
Conclusions. Cultural influences play an important role in the consultation process where patients’
behaviour is often bound in their cultural view of health care. Patients’ presentation of
their condition makes diagnosis difficult but can also lead to miscommunication. Whether South
Asian people are more likely to present mental health problems as chronic pain is not clear and
warrants further investigation.