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 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 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.

scholarly journals Chronic pain management strategies used by low-income overweight Latinos

2012 ◽  
Vol 9 (2) ◽  
pp. 133-144 ◽  
Author(s):  
Dana N Rutledge ◽  
Patricia J Cantero ◽  
Jeanette E Ruiz
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Low Income ◽  
Management Strategies ◽  
Chronic Pain Management

Reducing Medication Use in a Chronic Pain Management Program

1983 ◽  
Vol 40 (12) ◽  
pp. 2156-2158 ◽  
Author(s):  
Joy E. Kientz ◽  
Dana S. Fitzsimmons ◽  
Philip J. Schneider
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Medication Use ◽  
Management Program ◽  
Chronic Pain Management ◽  
Pain Management Program

scholarly journals The Impact of Pain Invisibility on Patient-Centered Care and Empathetic Attitude in Chronic Pain Management

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Emilie Paul-Savoie ◽  
Patricia Bourgault ◽  
Stéphane Potvin ◽  
Emilie Gosselin ◽  
Sylvie Lafrenaye
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Clinical Experience ◽  
Patient Centered Care ◽  
Chronic Pain Management ◽  
Patient Centered ◽  
Chronic Pain Patients ◽  
Centered Care ◽  
The Impact ◽  
Pain Patients

Objectives. The use of interdisciplinary patient-centered care (PCC) and empathetic behaviour seems to be a promising avenue to address chronic pain management, but their use in this context seems to be suboptimal. Several patient factors can influence the use of PCC and empathy, but little is known about the impact of pain visibility on these behaviours. The objective of this study was to investigate the influence of visible physical signs on caregiver’s patient-centered and empathetic behaviours in chronic pain context. Methods. A convenience sample of 21 nurses and 21 physicians participated in a descriptive study. PCC and empathy were evaluated from self-assessment and observer’s assessment using a video of real patients with chronic pain. Results. The results show that caregivers have demonstrated an intraindividual variability: PCC and empathetic behaviours of the participants were significantly higher for patients who have visible signs of pain (rheumatoid arthritis and complex regional pain syndrome) than for those who have no visible signs (Ehler–Danlos syndrome and fibromyalgia) (p<0.001). Participants who show a greater difference in their patient-centered behaviour according to pain visibility have less clinical experience. Discussion. The pain visibility in chronic pain patients is an important factor contributing to an increased use of PCC and empathy by nurses and physicians, and clinical experience can influence their behaviours. Thus, pain invisibility can be a barrier to quality of care, and these findings reinforce the relevance to educating caregivers to these unconscious biases on their behaviour toward chronic pain patients.

scholarly journals A Practice Based Chronic Pain Management Registry (CPMR): Structure and Content of Proposed Patient and Patient/Provider Platforms

2019 ◽  
Vol 10 (1) ◽  
pp. 11
Author(s):  
Paul Langley
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Pain Intensity ◽  
Functional Status ◽  
Response To Therapy ◽  
Chronic Pain Management ◽  
Physician Practices ◽  
Management Interventions ◽  
Therapy Interventions ◽  
The Impact

Previous commentaries in the Formulary Evaluation section of INNOVATIONS in Pharmacy have pointed to the difficulties of establishing the credibility of trial-based and modeled claims for therapy interventions. Claims for interventions in the management of chronic pain are no exception. To meet this challenge, the Chronic Pain Management Registry (CPMR) has been designed to provide an evidence base for physician practices and health care decision makers to evaluate the impact of pain management interventions. The purpose of this commentary is to detail the development, structure and content of the CPMR in two versions: (i) a patient response version and (ii) a combined patient/provider response version. The CPMR has a potentially critical role to play in providing a framework for the effective auditing of practice compliance in the prescribing and monitoring of opioids in the management of chronic pain. The CPMR tracks, with on-line input from the patient and the treating physician, the process and outcomes of therapy interventions. These reports cover the overall pain experience of patients as well as pain intensity and functional status by eleven specific pain locations, covering both pharmacological and non-pharmacological interventions. Prior to each practice visit patients complete reports which are entered to the CPMR with a summary transmitted to the physician practice. Over time, these reports track the cumulative response to therapy as well as the perception of the patients as to whether or not the therapy has led to any substantive improvement in activity limitations, symptoms and quality of life. A particular focus of the CPMR is on monitoring and evaluating the experience with, and impact of opioid medications, to include the effectiveness of opioid formulations on reducing pain intensity and improving functional status, including an intensive assessment of the potential for and experience of opioid substance abuse for individual patients. The CPMR can also support monthly reports to the practice to summarize patient throughput, the response to care by target pain patients and profiles of opioid use and abuse. The CPMR can be customized to meet the needs of individual practices.   Article Type: Commentary

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