Pivoting to virtual delivery for managing chronic pain with nonpharmacological treatments

Pain ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Julie M. Fritz ◽  
Alison F. Davis ◽  
Diana J. Burgess ◽  
Brian Coleman ◽  
Chad Cook ◽  
...  
Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3574-3584
Author(s):  
Cheryl Bernstein ◽  
Andrea G Gillman ◽  
Di Zhang ◽  
Anna E Bartman ◽  
Jong-Hyeon Jeong ◽  
...  

Abstract Objective High-quality chronic pain care emphasizes multimodal treatments that include medication and nonpharmacological treatments. But it is not clear which patients will participate in nonpharmacological treatments, such as physical therapy or mental health care, and previous research has shown conflicting evidence. Methods We used the Patient Outcomes Repository for Treatment (PORT) registry, which combines patient-reported outcomes data with electronic medical records. In this retrospective observational study, we performed two separate multinomial regression analyses with feature selection to identify PORT variables that were predictive of 1) recommendation of a nonpharmacological treatment by the provider and 2) patient participation in nonpharmacological treatments. Two hundred thirty-six patients were recommended (REC) or not recommended (NO REC) a nonpharmacological treatment, and all REC patients were classified as participating (YES) or not participating (NO) in the recommendations. Results Female gender and a diagnosis of Z79 “Opioid drug therapy” were significant positive and negative predictors of nonpharmacological treatment recommendations, respectively. Schedule II opioid use at initial presentation and recommendations for rehabilitation therapy were significant predictors of nonparticipation. Conclusions Patients using opioids are less likely to be recommended nonpharmacological treatments as part of multimodal chronic pain care and are less likely to participate in nonpharmacological treatments once recommended. Males are also less likely to be recommended nonpharmacological treatments. Patients referred for rehabilitation therapies are less likely to comply with those recommendations. We have identified patients in vulnerable subgroups who may require additional resources and/or encouragement to comply with multimodal chronic pain treatment recommendations.


2020 ◽  
Vol 52 (5) ◽  
pp. 361-363
Author(s):  
Kimberly Zoberi Schiel ◽  
Kelly M. Everard

Background and Objectives: The management of chronic pain is an important topic for training competent family physicians. The purpose of this study was to determine factors in teaching about chronic pain and whether state overdose death rates were associated with teaching chronic pain topics. Methods: Data were collected as part of the 2019 Council of Academic Family Medicine Educational Research Alliance (CERA) Clerkship Directors’ Survey. The response rate was 71%. Respondents answered questions about the amount of time spent teaching about chronic pain diagnoses, approach to chronic pain, opioid medications, nonopioid medications and nonpharmacologic treatments for chronic pain. Results: The most frequent topic was chronic pain diagnoses, taught by 64% of clerkships with an average of 92 minutes spent on the topic. Each chronic pain topic was taught by nearly 50% of clerkships, and 72.3% of clerkships taught at least one topic. More clerkships were teaching about opioids, nonopioids, and nonpharmacological treatments for chronic pain than in 2014. Time currently spent teaching about opioids was positively correlated with clerkships’ state 2014 drug overdose death rate. Conclusions: The majority of family medicine clerkships teach about chronic pain, and the amount of time dedicated to this topic has increased over the last 5 years. A state’s opioid overdose rate correlates with the amount of time spent teaching about opioids, but does not correlate with the amount of time teaching about other chronic pain subtopics. It is possible that the opioid crisis is causing a shift in the subtopics of chronic pain teaching.


2000 ◽  
Vol 27 (10) ◽  
pp. 834-841 ◽  
Author(s):  
O. Plesh ◽  
D. Curtis ◽  
J. Levine ◽  
W. D. Mccall Jr

Ob Gyn News ◽  
2005 ◽  
Vol 40 (10) ◽  
pp. 34
Author(s):  
SHERRY BOSCHERT
Keyword(s):  

2005 ◽  
Vol 38 (13) ◽  
pp. 12
Author(s):  
COLIN NELSON
Keyword(s):  

2006 ◽  
Vol 39 (19) ◽  
pp. 18
Author(s):  
ROXANNE NELSON
Keyword(s):  

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