Improving Pain Care with Project ECHO in Community Health Centers

Abstract

ObjectivePain is an extremely common complaint in primary care, and patient outcomes are often suboptimal. This project evaluated the impact of Project ECHO Pain videoconference case-based learning sessions on knowledge and quality of pain care in two Federally Qualified Health Centers.DesignQuasi-experimental, pre-post intervention, with comparison group.SettingTwo large, multisite federally qualified health centers in Connecticut and Arizona.SubjectsIntervention (N = 10) and comparison (N = 10) primary care providers.MethodsPrimary care providers attended 48 weekly Project ECHO Pain sessions between January and December 2013, led by a multidisciplinary pain specialty team. Surveys and focus groups assessed providers’ pain-related knowledge and self-efficacy. Electronic health record data were analyzed to evaluate opioid prescribing and specialty referrals.ResultsCompared with control, primary care providers in the intervention had a significantly greater increase in pain-related knowledge and self-efficacy. Providers who attended ECHO were more likely to use formal assessment tools and opioid agreements and refer to behavioral health and physical therapy compared with control providers. Opioid prescribing decreased significantly more among providers in the intervention compared with those in the control group.ConclusionsPain is an extremely common and challenging problem, particularly among vulnerable patients such as those cared for at the more than 1,200 Federally Qualified Health Centers in the United States. In this study, attendance at weekly Project ECHO Pain sessions not only improved knowledge and self-efficacy, but also altered prescribing and referral patterns, suggesting that knowledge acquired during ECHO sessions translated into practice changes.

Optimizing telehealth pain care after COVID-19

“…Educational initiatives to improve outcomes may include continued use and enhanced engagement in provider-to-provider telementoring, such as Extension for Community Healthcare Outcomes 53 and UW's TelePain programs, 67 , 84 which were implemented to support community providers over a decade ago. The value of pain management telementoring programs is supported by several studies, with demonstrations of increased provider knowledge and/or confidence, 2 , 5 , 31 , 53 , 67 improved communication between patients and providers, 5 , 17 greater guideline adherence, 2 and cost benefits relative to specialty clinic visits. 85 Systemic changes (eg, leadership buy-in and modified clinic schedules) that increase the feasibility of regular participation in telementoring may be necessary.…”

Overcoming Barriers for Uptake and Continued Use of Home Dialysis: An NKF-KDOQI Conference Report

“…Most studies have demonstrated success in enhancing knowledge base, care provider self-efficacy, and promotion of care team integration. [12][13][14] Furthermore, mixed-model studies and quantitative analyses have evaluated the patient and care partner satisfaction of Project ECHO. 12 Most published studies have confirmed a high degree of professional and patient satisfaction.…”

“…[12][13][14] Furthermore, mixed-model studies and quantitative analyses have evaluated the patient and care partner satisfaction of Project ECHO. 12 Most published studies have confirmed a high degree of professional and patient satisfaction. 15 Our task force envisions that our pilot Project ECHO should be trialed with 3 to 4 high-performing home dialysis centers.…”

Health care providers’ experiences and perceptions participating in a chronic pain telementoring education program: A qualitative study

“…Other studies have demonstrated that the ECHO program increases HCPs' self-efficacy and knowledge. [26][27][28][29][30] Previous research from our team has highlighted the impact of ECHO PAIN on HCPs' confidence, knowledge, and clinical practices, as well as the importance of the development of a community of practice. [31][32][33] Our results in this study suggest that HCPs recognize a knowledge gap in pain management.…”