P-008 - (Poster #8) National Trends in Acute Pain Management: Preliminary Insights from a 2025 Pain Management Survey

Background: Acute and chronic pain affect over 20% of U.S. adults, with a disproportionate burden on older adults and socioeconomically disadvantaged populations (Pitcher 2023). Pain leads to significant healthcare costs, lost productivity, and diminished quality of life (Institute of Medicine 2011). National guidelines from the CDC, ACOG, HHS, and ACP/AAFP recommend multimodal, evidence-based approaches that emphasize non-opioid therapies when appropriate (CDC 2022; ACOG 2021; HHS 2019; ACP/AAFP 2020). Despite this, many healthcare professionals report low confidence in using non-opioid alternatives, contributing to persistent opioid reliance (Steinberg 2024; Josi 2025). This disconnect between guidelines and practice underscores the need to better understand current prescribing behaviors and barriers to non-opioid pain management, especially as the healthcare system seeks to reduce opioid-related harms and improve patient-centered care.

Purpose/Objectives: The Medscape Pain Management Survey was designed to capture a snapshot of current practices across U.S.-based clinicians and assess the use of over-the-counter (OTC) and prescription analgesics, barriers to non-opioid pain management, and attitudes toward the perceived effectiveness of OTC options. By analyzing national survey data, we aimed to identify clinical practice gaps and opportunities for enhancing pain care consistent with recommended guidelines, while minimizing opioid exposure to serve as a starting point for creating continuing medical education courses.

Methods: A 22-question online survey was piloted from May 12, 2025-June 6, 2025 using Medscape’s platform. A stratified random sampling approach was employed to ensure a representative respondent pool. Participants were randomly selected from Medscape’s provider database using key stratification variables, including National Provider Identifier (NPI), years in practice, demographics, specialty, and geographic location. The survey consisted multiple-choice questions and ranking questions, designed to assess prescribing behaviors and attitudes toward various acute pain management strategies. Topics included commonly treated pain types, medication preferences (OTC, non-opioid, opioid), perceived patient expectations, and barriers to adopting non-opioid regimens. Data were analyzed descriptively, with frequencies and percentages reported for categorical variables. Comparative ranking scores were computed to assess the relative importance of treatment selection factors and prescribing barriers. The study aimed to generate preliminary actionable insights to inform future education and guideline dissemination initiatives related to pain management. This survey will run for an additional 5 months and expand availability to other specialties and professions throughout the U.S.

Results: A total of 127 healthcare professionals responded during the initial survey time period (May 12, 2025-June 6, 2025), representing a diverse mix of disciplines including dentists, primary care providers, and pain management specialists. The 3 most frequently treated pain conditions included post-procedural pain after minor office procedures (54%), back pain, and dental pain (both 45%). Across these indications, NSAIDs, particularly prescription-strength ibuprofen (800 mg), emerged as the most commonly used agent. Fixed-dose combinations of ibuprofen/acetaminophen were also frequently reported, especially for dental and procedural pain.
When asked about the most common agents used within regimens in clinical practice, the top selections included:

• Post-Procedural Pain: Ibuprofen 800 mg Rx (25%), ibuprofen 600 mg Rx and OTC 2-tablet ibuprofen (both 20%), and acetaminophen 500 mg OTC (21%)


• Back Pain: Acetaminophen 1000 mg OTC (21.1%), Ibuprofen 2 tablets OTC (18.4%), and Ibuprofen 800 mg Rx (16.5%)  


• Dental Pain: Ibuprofen Rx 800 mg (23%), Acetaminophen 1000 mg OTC (22%) Ibuprofen Rx 600 mg (21%)

Comparative scores ranking the top 6 factors that influence your choice of pain medication (ranked in order of importance: 1 = most important, 6 = least important) were calculated to assess key decision factors in treatment selection. “Efficacy in pain relief” received the lowest mean score indicating it was the most important factor among respondents. This was followed by “side effect profile” and “risk of addiction/misuse”. These scores may indicate a prioritization of effectiveness and safety in analgesic selection over formal guidelines.
For barriers to non-opioid use, the leading factor was “patient perception of OTC medications as less effective” followed by “the provider’s perception of effectiveness” and “concerns about gastrointestinal side effects of NSAIDs” and “cardiovascular side effects of NSAIDs.” Regarding the use of opioids, “higher perceived efficacy than OTC alternatives” was the top reason, with “patient expectation/demand” and “insurance coverage” also influencing decisions.
Despite the availability of guideline-endorsed non-opioid strategies, nearly all respondents (93%) agreed that patients often undervalue OTC medications simply because they are not prescription-based.

Conclusions/Implications for future research and/or clinical care: Our pilot survey findings suggest the need for improved communication tools, comparative efficacy data, and decision-support resources to reinforce confidence in non-opioid prescribing and to align real-world practice with evidence-based pain management guidelines. While national recommendations emphasize non-opioid multimodal strategies, the persistent use of opioids and hesitancy toward OTC alternatives may reflect systemic gaps in provider training and patient education. Clinicians frequently cited patient expectations, lack of viable alternatives, and concerns about the safety or effectiveness of OTC agents as significant barriers to their broader use.
The goal of this survey is to inform future initiatives that may focus on closing the knowledge-to-practice gap by equipping clinicians with outcome data, prescribing algorithms, and educational content that promotes safe and effective non-opioid options. Addressing these gaps is critical to advancing patient-centered care and reducing reliance on opioids in acute pain management settings.