Shared Medical Appointments for Managing Pain in Primary Care Settings?

Coates, Jonathan; Gething, Fraser; Johnson, Mark I.

doi:10.2217/pmt-2017-0016

Cited by 4 publications

(5 citation statements)

References 21 publications

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“…Group-based care has been proposed as an effective and efficient way to deliver multimodal pain treatments. 18,19 Home group sessions started with a ''check-in'' where participants could share their emotions, thoughts, hopes, and fears related to their health and provide updates since the last session. Group sessions, led by a health educator with years of experience as a group facilitator and a coordinator who had worked as a mental health case manager, involved principles of CBT and fostered peer support.…”

Section: Methods: Do-ipmp Design and Implementationmentioning

confidence: 99%

Design, Implementation, and Evaluation of an Integrative Pain Management Program in a Primary Care Safety-Net Clinic

Hurstak

Chao

Leonoudakis-Watts

et al. 2019

The Journal of Alternative and Complementary Medicine

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Objective: To design, implement, and evaluate a comprehensive Integrative Pain Management Program (IPMP) for patients with chronic pain in a safety-net primary care clinic. Design: We used a quality improvement ''Plan Do Study Act'' (PDSA) framework to design, refine, and evaluate an integrative chronic pain program. Setting: An urban federally qualified health center located in a community with high rates of chronic pain, substance use, and opioid overdose. Subjects: Eligible participants included individuals with pain for greater than 3 months who were prescribed opioid therapy. Outcome measures: We designed IPMP using a PDSA framework that promotes continuous evaluation and adaptation of the program to meet the needs of the clinical system. We assessed feasibility and acceptability with program referrals and attendance and evaluated program satisfaction. Results: The IPMP delivered a 12-week group-based intervention that involved group support, education on pain etiology and treatments, movement-based interventions, mindfulness-based therapies, acupuncture, and massage therapy. One hundred forty-six patients were referred to IPMP; 58 individuals participated in one of the first three cohorts of the program. Sixty-two percent of participants attended at least half of the sessions. Staff and participants reported high levels of satisfaction with IPMP and demand for longitudinal services. Conclusions: An IPMP delivered within a safety-net primary care clinic could be implemented in a way feasible and acceptable to staff and participants with the support of the local health care system. The application of a PDSA cycle allowed for rigorous implementation and evaluation of a multimodal pain program. Quality improvement frameworks are a strategy to improve and expand the delivery of high-quality patient-centered integrative pain treatments.

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Section: Methods: Do-ipmp Design and Implementationmentioning

confidence: 99%

Design, Implementation, and Evaluation of an Integrative Pain Management Program in a Primary Care Safety-Net Clinic

Hurstak

Chao

Leonoudakis-Watts

et al. 2019

The Journal of Alternative and Complementary Medicine

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“…This consultation often feels rushed with GPs having similar consultations with different patients over the course of a day. Shared appointments may be a more cost-effective model of service delivery than one-to-one consultations and have been successful for the management of diabetes, and obesity [64]. Shared appointments involve each patient consulting with the clinical team, with elements of group education and discussion between patients, and peer support by learning from the experiences of other patients.…”

Section: Service Delivery In Primary Carementioning

confidence: 99%

“…Patients impart information more readily in shared appointments and engagement with patients with similar conditions provides motivation for health behavior change. There is increasing use of shared medical appointments for persistent pain [64]. Moreover, physiotherapists and nurses may be better suited than GPs as a first point of contact to diagnose and advise patients with non-complex chronic pain [65].…”

Section: Service Delivery In Primary Carementioning

confidence: 99%

The Landscape of Chronic Pain: Broader Perspectives

Johnson

2019

Medicina

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Chronic pain is a global health concern. This special issue on matters related to chronic pain aims to draw on research and scholarly discourse from an eclectic mix of areas and perspectives. The purpose of this non-systematic topical review is to précis an assortment of contemporary topics related to chronic pain and its management to nurture debate about research, practice and health care policy. The review discusses the phenomenon of pain, the struggle that patients have trying to legitimize their pain to others, the utility of the acute–chronic dichotomy, and the burden of chronic pain on society. The review describes the introduction of chronic primary pain in the World Health Organization’s International Classification of Disease, 11th Revision and discusses the importance of biopsychosocial approaches to manage pain, the consequences of overprescribing and shifts in service delivery in primary care settings. The second half of the review explores pain perception as a multisensory perceptual inference discussing how contexts, predictions and expectations contribute to the malleability of somatosensations including pain, and how this knowledge can inform the development of therapies and strategies to alleviate pain. Finally, the review explores chronic pain through an evolutionary lens by comparing modern urban lifestyles with genetic heritage that encodes physiology adapted to live in the Paleolithic era. I speculate that modern urban lifestyles may be painogenic in nature, worsening chronic pain in individuals and burdening society at the population level.

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“…The strongest clinical evidence is in diabetes, where shared appointments result in demonstrable improvements in HbA1c and blood pressure. 4 Studies have, however, successfully used SMAs in many other conditions and settings, in primary and secondary care, including care for cancer survivors, 5 high use of medical care, 4 pain management, 6 substance misuse, 7 health screening for elderly people, 8 and chronic heart disease. 3 Technology, including video conferencing, has also been used to provide SMAs for patients living in rural areas or those with mobility difficulties.…”

Section: How and Where Do Shared Appointments Work?mentioning

confidence: 99%