scholarly journals An eCoach-Pain for Patients with Chronic Musculoskeletal Pain in Interdisciplinary Primary Care: A Feasibility Study

2021 ◽  
Vol 18 (21) ◽  
pp. 11661
Author(s):  
Cynthia Lamper ◽  
Ivan Huijnen ◽  
Maria de Mooij ◽  
Albère Köke ◽  
Jeanine Verbunt ◽  
...  
Keyword(s):  
Primary Care ◽  
Musculoskeletal Pain ◽  
Case Manager ◽  
Treatment Phase ◽  
Cost Effective ◽  
Chronic Musculoskeletal Pain ◽  
Added Value ◽  
Patient Specific ◽  
Practice Nurses ◽  
Support Cost

eHealth could support cost-effective interdisciplinary primary care for patients with chronic musculoskeletal pain. This study aims to explore the feasibility of the eCoach-Pain, comprising a tool measuring pain complexity, diaries, pain education sessions, monitoring options, and chat function. Feasibility was evaluated (June–December 2020) by assessing learnability, usability, desirability, adherence to the application, and experiences from patients and general practitioners, practice nurses mental health, and physiotherapists. Six primary healthcare professionals (PHCPs) from two settings participated in the study and recruited 29 patients (72% female, median age 50.0 years (IQR = 24.0)). PHCPs participated in a focus group. Patient data was collected by evaluation questionnaires, individual interviews, and eCoach-Pain-use registration. Patients used the eCoach during the entire treatment phase (on average 107.0 days (IQR = 46.0); 23 patients completed the pain complexity tool and used the educational sessions, and 12 patients the chat function. Patients were satisfied with the eCoach-Pain (median grade 7.0 (IQR = 2.8) on a 0–10 scale) and made some recommendations for better fit with patient-specific complaints. According to PHCPs, the eCoach-Pain is of added value to their treatment, and patients also see treatment benefits. However, the implementation strategy is important for successful use of the eCoach-Pain. It is recommended to improve this strategy and involve a case-manager per patient.

Impact of Depression on 12-Month Outcomes in Primary-Care Patients with Chronic Musculoskeletal Pain

2011 ◽  
Vol 20 (1) ◽  
pp. 8-17 ◽  
Author(s):  
Kurt Kroenke ◽  
Jingwei Wu ◽  
Matthew J. Bair ◽  
Teresa M. Damush ◽  
Erin E. Krebs ◽  
...  
Keyword(s):  
Primary Care ◽  
Musculoskeletal Pain ◽  
Chronic Musculoskeletal Pain ◽  
Primary Care Patients

scholarly journals The (cost-)effectiveness and cost-utility of a novel integrative care initiative for patients with chronic musculoskeletal pain: the pragmatic trial protocol of Network Pain Rehabilitation Limburg

2020 ◽  
Author(s):  
Cynthia Lamper ◽  
Ivan PJ Huijnen ◽  
Mariëlle EJB Goossens ◽  
Bjorn Winkens ◽  
Dirk Ruwaard ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Musculoskeletal Pain ◽  
Healthcare Costs ◽  
Healthcare Professionals ◽  
Cost Utility ◽  
Chronic Musculoskeletal Pain ◽  
Local Networks ◽  
Quadruple Aim ◽  
The Cost

Abstract Background: Rehabilitation care for patients with chronic musculoskeletal pain (CMP) is not optimally organized. The Network Pain Rehabilitation Limburg 2.0 (NPRL2.0) provides integrated care with a biopsychosocial approach and strives to improve the Quadruple Aim outcomes: pain-related disability of patients with CMP; experiences of care of patients with CMP; meaning in the work of healthcare professionals; and healthcare costs. Firstly, in this study, the effectiveness (with regard to the functioning and participation of patients) of primary care for patients with CMP will be assessed, comparing care organized following the NPRL2.0 procedure with usual care. Secondly, the cost-effectiveness and cost-utility with regard to health-related quality of life and healthcare costs will be assessed. And thirdly, the effect of duration of participation in a local network in primary care will be studied. Methods: In this pragmatic study, it is expected that two local networks with 105 patients will participate in the prospective cohort study and six local networks with 184 patients in the stepped-wedge based design. Healthcare professionals in the local networks will recruit patients. Inclusion criteria: age ≥ 18 years; having CMP; willing to improve functioning despite pain; and adequate Dutch literacy. Exclusion criteria: pregnancy; and having a treatable medical or psychiatric disease. Patients will complete questionnaires at baseline (T1), 3 months (T2), 6 months (T3), and 9 months (T4). Questionnaires at T1 and T4 will include the Pain Disability Index and Short Form Health Survey. Questionnaires at T1, T2, T3, and T4 will include the EQ-5D-5L, and iMTA Medical Consumption and Productivity Cost Questionnaires. Outcomes will be compared using linear mixed-model analysis and costs will be compared using bootstrapping methods. Discussion: NPRL2.0 is a multidimensional, complex intervention, executed in daily practice, and therefore needing a pragmatic study design. The current study will assess NPRL2.0 with respect to the Quadruple Aim outcomes: patient health and costs. This will provide more information on the (cost-) effectiveness of the organization of care in a network structure regarding patients with CMP. The other two Quadruple Aim outcomes will be examined alongside this study. Trial registration: Netherlands Trial Register: NL7643

scholarly journals Primary Care Utilization among Veterans with Chronic Musculoskeletal Pain: A Retrospective Chart Review

Pain Medicine ◽  
2013 ◽  
Vol 14 (7) ◽  
pp. 1021-1031 ◽  
Author(s):  
Gregory P. Beehler ◽  
Amy E. Rodrigues ◽  
Denise Mercurio-Riley ◽  
Andrew S. Dunn
Keyword(s):  
Primary Care ◽  
Musculoskeletal Pain ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Chronic Musculoskeletal Pain ◽  
Care Utilization ◽  
Primary Care Utilization

scholarly journals The (cost-)effectiveness and cost-utility of a novel integrative care initiative for patients with chronic musculoskeletal pain: the pragmatic trial protocol of Network Pain Rehabilitation Limburg

2020 ◽  
Author(s):  
Cynthia Lamper ◽  
Ivan PJ Huijnen ◽  
Mariëlle EJB Goossens ◽  
Bjorn Winkens ◽  
Dirk Ruwaard ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Musculoskeletal Pain ◽  
Healthcare Costs ◽  
Healthcare Professionals ◽  
Cost Utility ◽  
Chronic Musculoskeletal Pain ◽  
Local Networks ◽  
Quadruple Aim ◽  
The Cost

Abstract Background: Rehabilitation care for patients with chronic musculoskeletal pain (CMP) is not optimally organized. The Network Pain Rehabilitation Limburg 2.0 (NPRL2.0) provides integrated care with a biopsychosocial approach and strives to improve the Quadruple Aim outcomes: pain-related disability of patients with CMP; experiences of care of patients with CMP; meaning in the work of healthcare professionals; and healthcare costs. Firstly, in this study, the effectiveness (with regard to the functioning and participation of patients) of primary care for patients with CMP will be assessed, comparing care organized following the NPRL2.0 procedure with usual care. Secondly, the cost-effectiveness and cost-utility with regard to health-related quality of life and healthcare costs will be assessed. And thirdly, the effect of duration of participation in a local network in primary care will be studied. Methods: In this pragmatic study, it is expected that two local networks with 105 patients will participate in the prospective cohort study and six local networks with 184 patients in the stepped-wedge based design. Healthcare professionals in the local networks will recruit patients. Inclusion criteria: age ≥ 18 years; having CMP; willing to improve functioning despite pain; and adequate Dutch literacy. Exclusion criteria: pregnancy; and having a treatable medical or psychiatric disease. Patients will complete questionnaires at baseline (T1), 3 months (T2), 6 months (T3), and 9 months (T4). Questionnaires at T1 and T4 will include the Pain Disability Index and Short Form Health Survey. Questionnaires at T1, T2, T3, and T4 will include the EQ-5D-5L, and iMTA Medical Consumption and Productivity Cost Questionnaires. Outcomes will be compared using linear mixed-model analysis and costs will be compared using bootstrapping methods. Discussion: NPRL2.0 is a multidimensional, complex intervention, executed in daily practice, and therefore needing a pragmatic study design. The current study will assess the NPRL2.0 with respect to the Quadruple Aim’s outcomes of effectiveness of healthcare and economic consequences. The other two Quadruple Aim outcomes will be examined alongside this study, providing a broad scope of the performance of NPRL2.0. Trial registration: Netherlands Trial Register: NL7643; Registered 5 April 2019. https://www.trialregister.nl/trial/7643

scholarly journals Opioid prescribing for chronic musculoskeletal pain in UK primary care: results from a cohort analysis of the COPERS trial

BMJ Open ◽  
2018 ◽  
Vol 8 (6) ◽  
pp. e019491 ◽  
Author(s):  
Tomi Ashaye ◽  
Natalia Hounsome ◽  
Dawn Carnes ◽  
Stephanie J C Taylor ◽  
Kate Homer ◽  
...  
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
Musculoskeletal Pain ◽  
Controlled Trial ◽  
Cohort Analysis ◽  
Chronic Musculoskeletal Pain ◽  
National Guidelines ◽  
Opioid Prescribing ◽  
Link Type ◽  
Strong Opioids

Objective To establish the level of opioid prescribing for patients with chronic musculoskeletal pain in a sample of patients from primary care and to estimate prescription costs. Design Secondary data analyses from a two-arm pragmatic randomised controlled trial (COPERS) testing the effectiveness of group self-management course and usual care against relaxation and usual care for patients with chronic musculoskeletal pain (ISRCTN24426731). Setting 25 general practices and two community musculoskeletal services in the UK (London and Midlands). Participants 703 chronic pain participants; 81% white, 67% female, enrolled in the COPERS trial. Main outcome measures Anonymised prescribing data over 12 months extracted from GP electronic records. Results Of the 703 trial participants with chronic musculoskeletal pain, 413 (59%) patients were prescribed opioids. Among those prescribed an opioid, the number of opioid prescriptions varied from 1 to 52 per year. A total of 3319 opioid prescriptions were issued over the study period, of which 53% (1768/3319) were for strong opioids (tramadol, buprenorphine, morphine, oxycodone, fentanyl and tapentadol). The mean number of opioid prescriptions per patient prescribed any opioid was 8.0 (SD=7.9). A third of patients on opioids were prescribed more than one type of opioid; the most frequent combinations were: codeine plus tramadol and codeine plus morphine. The cost of opioid prescriptions per patient per year varied from £3 to £4844. The average annual prescription cost was £24 (SD=29) for patients prescribed weak opioids and £174 (SD=421) for patients prescribed strong opioids. Approximately 40% of patients received >3 prescriptions of strong opioids per year, with an annual cost of £236 per person. Conclusions Long-term prescribing of opioids for chronic musculoskeletal pain is common in primary care. For over a quarter of patients receiving strong opioids, these drugs may have been overprescribed according to national guidelines. Trial registration number ISRCTN24426731; Post-results.

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