BACKGROUND: @entity1 with chronic conditions and multiple comorbidities represent a growing challenge for health care globally. Improved coordination of care is considered essential for providing more effective and cost-efficient care for these @entity1 with complex needs. @entity571 is one of the most common and debilitating chronic conditions, is the most frequent cause of @entity1118 yet @entity571 care is often poorly-coordinated. Primary care is usually the first contact for @entity1 requiring relief from @entity1118 . Our previous work suggests discordance between the policy goals of improving @entity1 care and the experience of @entity571 @entity1 . We plan to investigate the empirical context of the primary care setting by focusing on primary physicians' conceptualizations and performance of their work in treating complex @entity1 with @entity1118 . This will allow for an exploration of how primary health care is - or could be - integrated with other services that play an important role in health care delivery. METHODS: Our study is an Institutional Ethnography of pain management in family medicine, to be carried out in three phases over 3  years from 2014/15 to 2018. Over the first year we will undertake approximately 80 key informant interviews with primary care physicians, other health care providers, policymakers and clinical experts. In the second year we will focus on mobilizing our networks from year one to assist in the collection of key texts which shape the current context of care. These texts will be analyzed by the research team. In the final year of the study we will focus on synthesizing our findings in order to map the social relations informing care. As is standard and optimal in qualitative research, analysis will be concurrent with data collection. DISCUSSION: Our study will allow us to identify how the work of coordinating care across multiple settings is accomplished, in practice as well as discursively and textually. Ultimately, we will identify links between everyday experience of care for @entity1 with @entity1118 , and broader discourses related to health care system inefficiencies, integration and @entity1 -centred care. An expected outcome of this study will be the development of new, or augmentation of existing, models of care, that are based in the local realities of primary care practice.

An institutional ethnography of XXXX management in family medicine (COPE) study protocol.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity1118 :: ('MESH:D059350', 'Disease') :: ['chronic pain'] @entity571 :: ('MESH:D010003', 'Disease') :: ['osteoarthritis', 'Osteoarthritis']
@entity1118 :: (MESH:D059350,Disease) :: ['chronic pain']
