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

2021 ◽  
Vol 2 ◽  
Author(s):  
Zahabiya Campwala ◽  
Gregory Davis ◽  
Olga Khazen ◽  
Rachel Trowbridge ◽  
Melisande Nabage ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Healthcare Utilization ◽  
Multidisciplinary Care ◽  
The United States ◽  
Emergency Department Visits ◽  
Complex Patients ◽  
Tertiary Center ◽  
Chronic Pain Patients ◽  
The Impact ◽  
Pain Patients

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.

Cost Burden of Chronic Pain Patients in a Large Integrated Delivery System in the United States

Pain Practice ◽  
2015 ◽  
Vol 16 (8) ◽  
pp. 1001-1011 ◽  
Author(s):  
Peter W. Park ◽  
Richard D. Dryer ◽  
Rozelle Hegeman-Dingle ◽  
Jack Mardekian ◽  
Gergana Zlateva ◽  
...  
Keyword(s):  
United States ◽  
Chronic Pain ◽  
Delivery System ◽  
The United States ◽  
Cost Burden ◽  
Integrated Delivery System ◽  
Chronic Pain Patients ◽  
Integrated Delivery ◽  
Pain Patients

The impact of opioid-induced constipation among chronic pain patients with sufficient laxative use

2015 ◽  
Vol 69 (12) ◽  
pp. 1448-1456 ◽  
Author(s):  
R. J. LoCasale ◽  
C. J. Datto ◽  
M. K. Margolis ◽  
J. Tack ◽  
K. S. Coyne
Keyword(s):  
Chronic Pain ◽  
Laxative Use ◽  
Chronic Pain Patients ◽  
The Impact ◽  
Pain Patients

Monitoring outcomes during long-term opioid therapy for noncancer pain: Results with the Pain Assessment and Documentation Tool

2005 ◽  
Vol 1 (5) ◽  
pp. 257 ◽  
Author(s):  
Steven D. Passik, PhD ◽  
Kenneth L. Kirsh, PhD ◽  
Laurie Whitcomb, MA ◽  
Jeffrey R. Schein, PhD, MPH ◽  
Mitchell A. Kaplan, PhD ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Side Effects ◽  
Pain Assessment ◽  
The United States ◽  
Opioid Therapy ◽  
Chronic Pain Patients ◽  
Noncancer Pain ◽  
Documentation Tool ◽  
Pain Patients

The increasingly common practice of long-term opioid therapy for chronic noncancer pain must be guided by ongoing assessment of four types of outcomes: pain relief, function, side effects, and drug-related behaviors. Our objective was to gather initial pilot data on the clinical application of a specialized chart note, the Pain Assessment and Documentation Tool (PADT), which was developed and tested with 27 physicians. This pilot test provided the means to collect cross-sectional outcome data on a large sample of opioid-treated chronic pain patients. Each of the physician volunteers (located in a variety of settings across the United States) completed the PADT for a convenience sample of personally treated chronic pain patients who had received at least three months of opioid therapy. Completion of the PADT required a clinical interview, review of the medical chart, and direct clinical observation. Data from the PADTs were collated and analyzed. The results suggested that the majority of patients with chronic pain achieve relatively positive outcomes in the eyes of their prescribing physicians in all four relevant domains with opioid therapy. Analgesia was modest but meaningful, functionality was generally stabilized or improved, and side effects were tolerable. Potentially aberrant behaviors were common but viewed as an indicator of a problem (i.e., addiction or diversion) in only approximately 10 percent of cases. Using the PADT, physician ratings can be developed in four domains. In this sample, outcomes suggested that opioid therapy provided meaningful analgesia.

The impact of structural therapy on functioning and pain in chronic pain patients: A pilot study1

2007 ◽  
Vol 20 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Alice V. Fann ◽  
H.J. Spencer ◽  
Amelia F. Hammaker ◽  
Svetlana Kligman ◽  
Richard P. Gray
Keyword(s):  
Chronic Pain ◽  
Chronic Pain Patients ◽  
Structural Therapy ◽  
The Impact ◽  
Pain Patients

scholarly journals The Impact of the “Muslim Ban” Executive Order on Healthcare Utilization in Minneapolis-St. Paul, Minnesota

2020 ◽  
Author(s):  
Elizabeth A. Samuels ◽  
Lilla Orr ◽  
Elizabeth B. White ◽  
Altaf Saadi ◽  
Aasim I. Padela ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Emergency Department ◽  
Healthcare Utilization ◽  
The United States ◽  
Emergency Department Visits ◽  
Executive Order ◽  
Before And After ◽  
Muslim Majority ◽  
The Impact

AbstractObjectiveDetermine whether the 2017 “Muslim Ban” Executive Order impacted healthcare utilization by people born in Order-targeted nations living in the United States.MethodsWe conducted a retrospective cohort study of people living in Minneapolis-St. Paul, MN in 2016-2017 who were: 1) born in Order-targeted nations, 2) born in Muslim-majority nations not listed in the Order, and 3) born in the United States and non-Latinx. Primary outcomes were: 1) primary care visits, 2) missed primary care appointments, 3) primary care diagnoses for stress-responsive conditions, 4) emergency department visits, and 5) emergency department visits for stress-responsive diagnoses. We evaluated visit trends before and after Order issuance using linear regression and differences between study groups using a difference-in-difference analyses.ResultsIn early 2016, primary care visits and stress-responsive diagnoses increased among individuals from Muslim majority nations. Following the Order, there was an immediate increase in emergency department visits among individuals from Order-targeted nations.ConclusionsIncreases in healthcare utilization among people born in Muslim majority countries before and after the “Muslim Ban” likely reflect elevated cumulative stress including the impact of the Order.

Temporal summation in chronic pain patients: the impact of catastrophizing, distraction analgesia and opioid use

2013 ◽  
Vol 14 (4) ◽  
pp. S54
Author(s):  
K. Schreiber ◽  
C. Campbell ◽  
C. Cahalan ◽  
G. Mensing ◽  
R. Edwards
Keyword(s):  
Chronic Pain ◽  
Temporal Summation ◽  
Opioid Use ◽  
Chronic Pain Patients ◽  
The Impact ◽  
Pain Patients

The Impact of Chronic Pain Patients' Psychotropic Drug Knowledge and Warning Labels on the Decision Whether to Drive a Car or Not

2006 ◽  
Vol 7 (4) ◽  
pp. 360-364 ◽  
Author(s):  
D. S. Veldhuijzen ◽  
A. J. M. van Wijck ◽  
J. C. Verster ◽  
C. J. Kalkman ◽  
J. L. Kenemans ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Psychotropic Drug ◽  
Warning Labels ◽  
Chronic Pain Patients ◽  
Drug Knowledge ◽  
The Impact ◽  
Pain Patients

scholarly journals Examination of Symptom Clusters in Acute and Chronic Pain Patients

2014 ◽  
Vol 3;17 (3;5) ◽  
pp. E349-E357
Author(s):  
David Fishbain
Keyword(s):  
Chronic Pain ◽  
Acute Pain ◽  
Severe Pain ◽  
Somatic Symptoms ◽  
The United States ◽  
Symptom Clusters ◽  
Pain Level ◽  
Cluster Number ◽  
Chronic Pain Patients ◽  
Pain Patients

Background: Symptom clusters have not been previously explored in acute pain patients (APPs) and chronic pain patients (CPPs) with non-cancer pain. Objectives: The objectives of this study were to determine in CPPs and APPs which somatic and non-somatic symptoms cluster with each other, the number of clusters, and if cluster number and cluster symptom makeup differ by pain level. Study Design: Study sample was 326 APPs and 341 CPPs who had completed a pool of questions that had included current symptom questions other than pain. Symptom cluster analyses were performed on 15 somatic and non-somatic symptoms for APPs and CPPs and for 2 CPP subgroups with moderate and severe pain. Setting: APPs and CPPs were from rehabilitation facilities located in 30 states in all geographical regions of the United States. Results: APPs had 4 symptom clusters and CPPs had 5. For CPPs, the clusters represented memory, neurological, behavioral, somatic, and autonomic problems. CPPs with moderate and severe pain had 3 and 4 symptom clusters, respectively, and differed in cluster symptom constitution. Limitations: Patients selected themselves for study inclusion and were paid for their participation. This could have affected random selection. Lastly, we used the current time definitions of acute pain versus chronic pain (90 days) to separate our patients into these groups. Currently, no consensus exists regarding the optimal time duration to divide acute from chronic. Conclusions: APPs and CPPs are characterized by symptom comorbidities that form clusters. In CPPs, cluster number and cluster symptom makeup are affected by pain level. This has implications for clinical practice and future research. Key words: Comorbidity, somatic symptoms, comorbid symptoms, chronic pain patients, acute pain patients, community patients without pain, clusters, symptom clusters

scholarly journals Impact of the COVID-19 pandemic on chronic pain management

2021 ◽  
Vol 2 (3) ◽  
pp. 197-212
Author(s):  
Andrew Auyeung ◽  
Hank Wang ◽  
Iulia Pirvulescu ◽  
Nebojša Knežević
Keyword(s):  
United States ◽  
Chronic Pain ◽  
Pain Management ◽  
The United States ◽  
Chronic Pain Management ◽  
Steroid Use ◽  
Chronic Pain Patients ◽  
Interventional Pain Management ◽  
Tools And Techniques ◽  
Pain Patients

Introduction: The COVID-19 pandemic has generated considerable turmoil in the interventional pain management (IPM) community. Due to IPM being classified as 'elective', numerous pain practices across the United States were forced to close during the pandemic, leaving chronic pain patients untreated for indefinite periods, and IPM physicians with increased stress and burnout. Results: In response to these detrimental effects, various re-opening tools and techniques have been created to facilitate a cautious resumption of in-person interventional pain practice. Due to their ability to minimize person-to-person contact, telehealth and pharmacotherapy played a more significant role in IPM during the pandemic, but their increased utilization has also led to the exacerbation of substance abuse and the opioid epidemic. The interplay between steroid use and its immunosuppressive effects, in relation to the COVID-19 infection and the COVID-19 vaccine, has also arisen as an issue of concern. Conclusion: As practices begin to safely re-open throughout the United States, the effects felt by chronic pain patients during the pandemic must be emphasized and not ignored. This review emphasizes the struggles pain patients have had to face during the pandemic and the need to update and redefine regulations regarding interventional and chronic pain management.

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