The Impact of Integrative Pain Management Courses on Provider Attitudes, Confidence, and Prescribing Patterns for Patients with Pain

Am J Med. 2026 Feb 13:S0002-9343(26)00113-0. doi: 10.1016/j.amjmed.2026.02.008. Online ahead of print.

ABSTRACT

PURPOSE: Chronic pain management remains a critical challenge despite policy efforts like Arizona's Prescription Monitoring Program. There is an ongoing need to enhance provider education in integrative, nonpharmacologic approaches to chronic pain.This study evaluated the impact of an Integrative Pain Management (IPM) program on healthcare providers' attitudes, confidence, and prescribing behaviors in chronic pain.

METHODS: This pre-post study evaluated a six-hour, online IPM program for licensed Arizona providers. Outcomes included changes in provider attitudes and beliefs, confidence with IPM, and prescribing patterns for opioid and other controlled medications. Prescribing records linked by national provider identifier obtained from the Arizona Board of Pharmacy were used as well as validated surveys. Participants were recruited through state boards and professional organizations.

RESULTS: Among 100 participants, most were female (76%), White (77%), and held Doctor of Medicine (48%) or Nurse Practitioner (24%) credentials. Significant improvements were found in attitudes toward chronic pain, pain-related beliefs, and medical knowledge (all p < .01), with no significant changes in prescribing patterns. Belief shifts included reduced negative stance toward pain patients (p < .001) and increased awareness of inadequate pain education (p = .032). Participating providers reported more frequent discussions on work-life balance (p = .019) and Ayurveda (p = .003). Pharmacy board data showed no significant prescribing changes over the one-year measurement period.

CONCLUSIONS: The IPM course improved provider attitudes and engagement in whole-person care but did not affect prescribing behaviours, highlighting the need to pair education with system and policy changes for lasting impact.

PMID:41692101 | DOI:10.1016/j.amjmed.2026.02.008