The Impact of Multidisciplinary Conferences on Healthcare Utilization in Chronic Pain Patients

Abstract

Approximately 100 million adults in the United States have chronic pain, though only a subset utilizes the vast majority of healthcare resources. Multidisciplinary care has been shown to improve outcomes in a variety of clinical conditions. There is concern that multidisciplinary care of chronic pain patients may overwhelm existing resources and increase healthcare utilization due to the volume of patients and the complexity of care. We report our findings on the use of multidisciplinary conferences (MDC) to facilitate care for the most complex patients seen at our tertiary center. Thirty-two of nearly 2,000 patients seen per year were discussed at the MDC, making up the top 2% of complex patients in our practice. We evaluated patients' numeric rating score (NRS) of pain, medication use, hospitalizations, emergency department visits, and visits to pain specialists prior to their enrollment in MDC and 1 year later. Matched samples were compared using Wilcoxon's signed rank test. Patients' NRS scores significantly decreased from 7.64 to 5.54 after inclusion in MDC (p < 0.001). A significant decrease in clinic visits (p < 0.001) and healthcare utilization (p < 0.05) was also observed. Opioid and non-opioid prescriptions did not change significantly (p = 0.43). 83% of providers agreed that MDC improved patient care. While previous studies have shown the effect of multi-disciplinary care, we show notable improvements with a team established around a once-a-month MDC.

Relationship between nurses' perceptions of the benefits/challenges of nursing and degree of interprofessional and intraprofessional collaboration in all‐inclusive services combining day services, overnight stays and home‐visit nursing for the older people living at home

“…This suggested that teams in which members (regardless of their profession) favorably communicated with each other and shared goals could achieve sufficient effects of care while reducing related challenges. These results supported those of previous studies that showed that interprofessional collaboration improved the quality of care for users 9,10 . A previous study showed that psychological safety strengthened the relationships among hospital nurses 19 .…”

“…These results supported those of previous studies that showed that interprofessional collaboration improved the quality of care for users. 9 , 10 A previous study showed that psychological safety strengthened the relationships among hospital nurses. 19 In this study, some nurses perceived there to be lower “Difficulty of cooperation among nurses because of differences in attitudes” when cooperation among nurses was stronger, which suggested that psychological safety among nurses strengthened cooperation and decreased the perceived difficulty in cooperation.…”

“…In the primary care context, interprofessional collaboration has been reported to improve pain care 9 . In addition, patient‐centered interdisciplinary interventions appear to be more effective than usual care 10 .…”

“…In the primary care context, interprofessional collaboration has been reported to improve pain care. 9 In addition, patient‐centered interdisciplinary interventions appear to be more effective than usual care. 10 Nursing and care services in MLSH are flexibly combined and provided according to the condition and needs of individual users.…”