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

Lookup NU author(s): Dr Matthew Breckons, Dr Susan BissettORCiD, Professor Catherine Exley, Professor Vera Araujo-SoaresORCiD, Professor Justin DurhamORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Persistent orofacial pain is relatively common and known to have an adverse effect on quality of life. Previous studies suggest that the current care pathway may be problematic but it is not well understood which health services patients access and their experience of this. The aim of this study was to explore care pathways and their impact from the perspective of patients. Qualitative interviews were conducted with a maximum variation sample of patients recruited from primary (community-based) and secondary (specialist hospital based) care in the UK. Questions focussed on the stages in their pathway and the impact of the care they had received. Interviews were digitally recorded and transcribed verbatim and analysis followed principles of the constant comparative method. NVivo 10 was used to help organise and analyse data. Twenty-two patients were interviewed at Baseline and 18 took part in a second interview at 12 months. Three main themes emerged from the data: the ‘fluidity of the care pathway’, in which patients described moving between different healthcare providers in attempts to have their pain diagnosed and managed, occurring alongside a ‘failure to progress’, where, despite multiple appointments patients described frustration at delays in obtaining a diagnosis and effective treatment for their pain. Throughout their care pathways patients described the ‘effects of unmanaged pain’ where the longer pain went unmanaged the greater its potential to negatively impact on patients’ lives. Findings of this study suggest that the current care pathway is inefficient and fails to meet patient needs. Future work needs to focus on working with stakeholder groups to redesign patient centred care pathways.

Publication metadata

Author(s): Breckons M, Bissett S, Exley C, Araujo-Soares V, Durham J

Publication type: Article

Publication status: Published

Journal: Journal of Dental Research Clinical and Translational Research

Year: 2017

Volume: 2

Issue: 1

Pages: 48-57

Print publication date: 01/01/2017

Online publication date: 16/11/2016

Acceptance date: 24/10/2016

Date deposited: 11/01/2017

ISSN (print): 2380-0844

ISSN (electronic): 2380-0852

Publisher: Sage


DOI: 10.1177/2380084416679648


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