Psychologists Say Improving Health Literacy Can Help Patients Treat, Manage Pain

From the April 2013 Desktop News | Chronic pain can be managed by developing alternative ways of thinking and perceiving it through cognitive behavior therapy (CBT). But in the health care system patients with a low literacy or educational level experience a disadvantage in learning and using these techniques.

Dr. Beverly E. Thorn, chair of the Department of Psychology, will work to make this type of treatment more accessible as the leader of a $1.27 million research project funded by the Patient-Centered Outcomes Research Institute to study different psychosocial treatments for the management of chronic pain. The project will focus on reducing disparities in chronic pain management by adapting two psychosocial treatments to reduce literacy barriers encountered by undereducated individuals.

According to Thorn, chronic pain affects more than 116 million Americans, costs $600 billion annually and is unequally borne by people in low-income brackets, especially ethnic minorities. This recent funding is the continuation of her research on methods to manage chronic pain using CBT.

“Just like someone with diabetes, chronic pain is a chronic illness without a cure, and it has to be managed,” said Thorn. “Someone with diabetes cannot simply take insulin or other medication without changing their daily habits. Someone with chronic pain cannot simply have multiple surgeries and take multiple medications without learning pain self-management skills. If someone learns to manage their own chronic condition better, that person will have fewer visits to the emergency department, will need fewer surgical interventions, and will feel the need to take less medication.”

Many individuals also have health literacy deficits, such as difficulty understanding their illness and difficulty navigating the health care system for treatment, Thorn said. These deficits place these individuals at a disadvantage in seeking and receiving adequate care. In addition, treatment for chronic pain usually relies on expensive medical interventions with negative side effects. Psychosocial treatments like pain education and CBT show promise but usually are unavailable or poorly adapted to the needs of people with lower educational attainment or lower health literacy.

“We are simplifying the patient materials and the treatment itself to make it easier for all patients to understand and incorporate into their lives,” Thorn said. “We think this will be particularly useful for patients with pain and low literacy.”

Thorn and her team will use the funds to build on an ongoing partnership with Whatley Health Services, a federally qualified health consortium that serves the Black Belt region of West Alabama. Thorn said the goal is to support widespread use of these psychosocial treatments in communities to offer good care and to reduce health care disparities for people with chronic pain.