PURPOSE The use of interventional pain management (IPM) modalities to alleviate chronic pain is increasing despite the lack of high-quality evidence. We undertook this survey to explore patterns, training, and attributes of IPM practice. METHODS We administered a 32-item survey via seven Canadian physician member organizations, whose members were engaged in the management of chronic pain. RESULTS Of 777 physicians contacted, 256 (33%) responded: 45 (6%) declined to participate and 211 (27%) agreed to participate; the number of participants answering any given question varied. One hundred and sixty-nine of 194 (87%) practiced IPM and 103 of 194 (53%) managed only non-cancer pain. Pain management training of ≥ six months was associated with higher odds of IPM training (odds ratio [OR], 2.98; 95% confidence interval [CI], 1.32 to 6.7), but not necessarily ongoing IPM practice (OR, 1.97; 95% CI, 0.74 to 5.3). A substantial percentage of physicians (108 of 168 [64%]) practiced IPM based only on training received during either their base residency program or courses. Only 48 of 186 (26%) felt that there were adequate opportunities for IPM training, and 69 of 186 (37%) believed that their colleagues practiced IPM in accordance with the best current evidence. CONCLUSIONS Our survey indicates that IPM practice and training were not uniform, and that interventional therapies for chronic pain may not be performed in accordance with the best available evidence. Our survey highlights a lack of IPM training opportunities, which may result in substandard training. Concerted efforts involving physician organizations and regulators are needed to standardize IPM training and develop clinical guidelines to optimize evidence-based practice.

中文翻译：

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慢性疼痛的介入性疼痛管理：对加拿大医生的一项调查。

目的尽管缺乏高质量的证据，但越来越多地采用介入性疼痛管理（IPM）模式来缓解慢性疼痛。我们进行了这项调查，以探讨IPM实施的模式，培训和属性。方法我们通过七个加拿大医师会员组织对32个项目进行了调查，该组织的成员从事慢性疼痛的管理。结果在联系的777名医生中，有256名（33％）回答：45名（6％）拒绝参加，而211名（27％）同意参加。回答任何给定问题的参与者数量各不相同。194名患者中有169名（87％）进行过IPM，194名患者中有103名（53％）仅进行了非癌性疼痛。≥6个月的疼痛管理培训与IPM培训的机率较高相关（赔率[OR]为2.98； 95％置信区间[CI]为1.32至6.7），但不一定是正在进行的IPM练习（OR为1.97； 95％CI为0.74至5.3）。很大比例的医生（168名中的108名，占[64％]）仅根据其基本居住计划或课程中接受的培训来实施IPM。186个中只有48个（26％）认为有足够的机会进行IPM培训，而186个中的69个（37％）认为他们的同事们根据最新的证据进行了IPM。结论我们的调查表明IPM的实践和培训并不统一，并且慢性疼痛的介入治疗可能未根据最佳证据进行。我们的调查突出表明缺乏IPM培训机会，这可能导致培训不合格。