scholarly journals Evaluation of an innovative tele-education intervention in chronic pain management for primary care clinicians practicing in underserved areas

2018 ◽  
Vol 25 (8) ◽  
pp. 484-492 ◽  
Author(s):  
Andrea D Furlan ◽  
Jane Zhao ◽  
Jennifer Voth ◽  
Samah Hassan ◽  
Ruth Dubin ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Nurse Practitioners ◽  
Self Efficacy ◽  
Healthcare Providers ◽  
Physician Assistants ◽  
Chronic Pain Management ◽  
Healthcare Outcomes ◽  
The Impact

Introduction Inadequate knowledge and training of healthcare providers are obstacles to effective chronic pain management. ECHO (extension for community healthcare outcomes) uses case-based learning and videoconferencing to connect specialists with providers in underserved areas. ECHO aims to increase capacity in managing complex cases in areas with poor access to specialists. Methods A pre-post study was conducted to evaluate the impact of ECHO on healthcare providers’ self-efficacy, knowledge and satisfaction. Type of profession, presenting a case, and number of sessions attended were examined as potential factors that may influence the outcomes Results From June 2014 to March 2017, 296 primary care healthcare providers attended ECHO, 264 were eligible for the study, 170 (64%) completed the pre-ECHO questionnaire and 119 completed post-ECHO questionnaires. Participants were physicians (34%), nurse practitioners (21%), pharmacists (13%) and allied health professionals (32%). Participants attended a mean of 15 ± 9.19 sessions. There was a significant increase in self-efficacy ( p < 0.0001) and knowledge ( p < 0.0001). Self-efficacy improvement was significantly higher among physicians, physician assistants and nurse practitioners than the non-prescribers group ( p = 0.03). On average, 96% of participants were satisfied with ECHO. Satisfaction was higher among those who presented cases and attended more sessions. Discussion This study shows that ECHO improved providers’ self-efficacy and knowledge. We evaluated outcomes from a multidisciplinary group of providers practicing in Ontario. This diversity supports the generalisability of our findings. Therefore, we suggest that this project may be used as a template for creating other educational programs on other medical topics.

scholarly journals An Innovative Electronic Health Toolkit (Our Whole Lives for Chronic Pain) to Reduce Chronic Pain in Patients With Health Disparities: Open Clinical Trial

10.2196/14768 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e14768
Author(s):  
Paula Gardiner ◽  
Salvatore D'Amico ◽  
Man Luo ◽  
Niina Haas
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Low Income ◽  
Self Efficacy ◽  
Medication Use ◽  
Pain Medication ◽  
Chronic Pain Management ◽  
Management Platform ◽  
Electronic Health ◽  
The Impact

Background Chronic pain affects millions of Americans. Our Whole Lives, an electronic health (eHealth) toolkit for Chronic Pain (Our Whole Lives for Chronic Pain [OWLCP]), is a mind-body chronic pain management platform that teaches self-management strategies to reduce pain impact and pain medication use. Objective The primary goal of this study was to evaluate the feasibility of OWLCP in reducing pain impact and pain-related outcomes. Methods We conducted a pre-post clinical study (2 cohorts) to assess the feasibility of OWLCP usage among low-income patients with chronic pain. Outcome data, collected at baseline and 9 weeks, included Patient-Reported Outcomes Measurement Information System (PROMIS-29), pain self-efficacy, and pain medication use. In the statistical analysis, we used descriptive statistics, logistic regression, linear regression, and qualitative methods. Results Among the enrolled 43 participants, the average age was 50 years, (39/43) 91% were female, (16/43) 37% were black, and (7/43) 16% were Hispanic. From baseline to follow-up, the PROMIS measures showed a reduction in depression (P=.02), pain interference (P=.003), and average pain impact score (P=.007). Pain self-efficacy increased ((P<.001), whereas opioid use had a 13% reduction (P=.03). Conclusions The eHealth chronic pain management platform, OWLCP, is a potential tool to reduce the impact of chronic pain for low-income racially diverse populations.

scholarly journals Educating Physicians in Family Medicine Residencies About Nonpharmacologic Approaches to Pain:

2020 ◽  
Vol 52 (3) ◽  
pp. 189-197
Author(s):  
Ann Marie Chiasson ◽  
Audrey J. Brooks ◽  
Mari Ricker ◽  
Patricia Lebensohn ◽  
Mei-Kuang Chen ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Family Medicine ◽  
Self Efficacy ◽  
Medical Knowledge ◽  
Primary Care Providers ◽  
Control Group ◽  
Chronic Pain Management ◽  
Care Providers ◽  
Pain Patients

Background and Objectives: Opioid misuse is at an all-time crisis level, and nationally enhanced resident and clinician education on chronic pain management is in demand. To date, broad-reaching, scalable, integrative pain management educational interventions have not been evaluated for effectiveness on learner knowledge or attitudes toward chronic pain management. Methods: An 11-hour integrative pain management (IPM) online course was evaluated for effect on resident and faculty attitudes toward and knowledge about chronic pain. Participants were recruited from family medicine residencies participating in the integrative medicine in residency program. Twenty-two residencies participated, with 11 receiving the course and 11 serving as a control group. Evaluation included pre/post medical knowledge and validated measures of attitude toward pain patients, self-efficacy for nondrug therapies, burnout, and compassion. Results: Forty-three participants (34.4%) completed the course. The intervention group (n=50), who received the course, improved significantly (P&lt;.05) in medical knowledge, attitude toward pain patients, and self-efficacy to prescribe nondrug therapies while the control group (n=54) showed no improvement. There was no effect on burnout or compassion for either group. The course was positively evaluated, with 83%-94% rating the course content and delivery very high. All participants responded that they would incorporate course information into practice, and almost all thought what they learned in the course would improve patient care (98%). Conclusions: Our findings demonstrate the feasibility of an online IPM course as an effective and scalable intervention for residents and primary care providers in response to the current opioid crisis and need for better management of chronic pain. Future directions include testing scalability in formats that lead to improved completion rates, implementation in nonacademic settings, and evaluation of clinical outcomes such as decreased opioid prescribing.

Identifying Teaming in Chronic Pain Management Interventions in Primary Care: A Systematic Review

2021 ◽  
Vol 2021 (1) ◽  
pp. 11391
Author(s):  
Karleen F. Giannitrapani ◽  
Natalie Connell ◽  
Pallavi Prathivadi ◽  
Sophia Zupanc ◽  
Hong-Nei Wong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Chronic Pain Management ◽  
Management Interventions

Tools, Time, Training, and Team—Military Primary Care Providers’ Perspectives on Improving Chronic Pain Assessment and Management

2021 ◽  
Author(s):  
Asha Mathew ◽  
Honor McQuinn ◽  
Diane M Flynn ◽  
Jeffrey C Ransom ◽  
Ardith Z Doorenbos
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Pain Assessment ◽  
Insurance Coverage ◽  
Primary Care Providers ◽  
Stepped Care ◽  
Chronic Pain Management ◽  
Care Providers ◽  
Pain Care

ABSTRACT Introduction Primary care providers are on the front lines of chronic pain management, with many reporting frustration, low confidence, and dissatisfaction in handling the complex issues associated with chronic pain care. Given the importance of their role and reported inadequacies and dissatisfaction in managing this challenging population, it is important to understand the perspectives of primary care providers when considering approaches to chronic pain management. This qualitative descriptive study aimed to comprehensively summarize the provider challenges and suggestions to improve chronic pain care in military primary care settings. Materials and Methods Semi-structured interviews with 12 military primary care providers were conducted in a single U.S. Army medical center. All interviews were audio-recorded and lasted between 30 and 60 minutes. Interview transcripts were analyzed using ATLAS 9.0 software. Narratives were analyzed using a general inductive approach to content analysis. The Framework Method was used to organize the codes and emergent categories. All study procedures were approved by the Institutional Review Board of the University of Washington. Results Four categories captured providers’ challenges and suggestions for improving chronic pain care: (1) tools for comprehensive pain assessment and patient education, (2) time available for each chronic pain appointment, (3) provider training and education, and (4) team-based approach to chronic pain management. Providers suggested use of the Pain Assessment Screening Tool and Outcomes Registry, more time per visit, incorporation of chronic pain care in health sciences curriculum, consistent provider training across the board, insurance coverage for complementary and integrative therapies, patient education, and improved access to interdisciplinary chronic pain care. Conclusions Lack of standardized multifaceted tools, time constraints on chronic pain appointments, inadequate provider education, and limited access to complementary and integrative health therapies are significant provider challenges. Insurance coverage for complementary and integrative health therapies needs to be expanded. The Stepped Care Model of Pain Management is a positive and definite stride toward addressing many of these challenges. Future studies should examine the extent of improvement in guidelines-concordant chronic pain care, patient outcomes, and provider satisfaction following the implementation of the Stepped Care Model of Pain Management in military health settings.

Ideas and innovations: Inclusion of pharmacists in chronic pain management services in a primary care practice

2017 ◽  
Vol 7 (6) ◽  
pp. 484-487
Author(s):  
Robin Moorman Li, PharmD ◽  
Rachel Hrabchak Franks, PharmD ◽  
Steven G. Dimmitt, DO ◽  
George R. Wilson, MD
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Care Physician ◽  
Care Practice ◽  
Chronic Pain Management ◽  
Proper Patient Selection ◽  
Pain Specialist

Nonmalignant chronic pain management involves an ongoing process of complex evaluations including proper patient selection, proper prescribing, and careful monitoring. In the Pain Management Refill Clinic, patients are stabilized on an opioid regimen by either a pain specialist or a primary care physician (PCP). The PCP assumes long-term prescription of the regimen and proper follow-up. The inclusion of pharmacists in the management of patients suffering from chronic pain has allowed the physicians to improve opioid prescribing, documentation, and monitoring in accordance with chronic nonmalignant pain guidelines.

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