scholarly journals Models of Care for Chronic Pain

2021 ◽  
Vol 1 (6) ◽  
Author(s):  
Kendra Brett ◽  
Danielle MacDougall
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Models Of Care ◽  
Stepped Care ◽  
Care Utilization ◽  
Care Model ◽  
Hub And Spoke ◽  
Delivery Of Care ◽  
Care Models ◽  
Oncology Care

For chronic pain, 1 hub-and-spoke model and 4 stepped care models for the delivery of care in Canada and internationally were identified and described. No information was found on the use of the Oncology Care Model for chronic pain. For other medical conditions, 9 stepped care models, 5 hub-and-spoke models, and the Oncology Care Model for the delivery of care in Canada and internationally were identified and described. Patient-related outcomes used to evaluate the effectiveness of models of care for chronic pain include pain measures (e.g., intensity, duration), psychosocial outcomes (e.g., anxiety, depression), functional outcomes (e.g., disability, employment status), and health care utilization (e.g., opioid prescriptions, health care visits). Various barriers and facilitators to providing care for patients with chronic pain were identified in the consultations and the literature. The most common factors that influenced the care provided to patients with chronic pain pertained to funding, support, and collaboration from the government and locally; having a centralized intake and referral system; and leveraging existing resources. There appears to be considerable variation in the models of care used to address the care needs of patients with chronic pain. In Canada, there are provincial, regional, and local models, and local programs; some regions do not have a formalized approach for the provision of care for chronic pain patients.

scholarly journals Editorial

2007 ◽  
Vol 31 (4) ◽  
pp. 498
Keyword(s):  
Health Care ◽  
Care Management ◽  
Models Of Care ◽  
Care Model ◽  
The Public ◽  
Australian Health ◽  
Care Models ◽  
Effectiveness And Efficiency ◽  
Regular Section ◽  
Health Review

THIS IS THE FOURTH ISSUE of Australian Health Review which has featured a ?Models of Care? section; now a regular section of the Journal. As 2007 draws to a close, the breadth of formalised care models (such as self-care management, case management and disease management) being implemented in the Australian health care system continues to be publicised. The number of Australian studies which evaluate the effectiveness and efficiency of care model interventions is increasing. Being the optimist, I predict that the rate of publication of these studies will also increase. This is fundamental because the value of any intervention needs carefully constructed evaluation that enables results to be debated by experts in the public domain.

Models of Care

2017 ◽  
Author(s):  
Tyson Sawchuk ◽  
Joan K. Austin ◽  
Debbie Terry
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Hospital Setting ◽  
Models Of Care ◽  
Stepped Care ◽  
Patient Centered ◽  
Care Approach ◽  
Centered Care ◽  
Care Models

This chapter addresses common barriers to care delivery in psychogenic nonepileptic seizures (PNES) and limitations of current approaches. Theoretical and practical considerations in delivering PNES care are discussed. These include a stepped-care approach, which offers a strategy for efficiently managing health care resources and has promise in treatment of PNES. Patient-centered care, a general approach to providing health care services in a manner that takes into consideration the patients’ expressed needs, desires, and preferences, is also considered. Examples of care models are presented, including a pediatric model for PNES recently developed and being tested in a Canadian hospital setting. Future directions for the development of care models in PNES are discussed and a list of recommendations is provided.

Navigating the health care system: perceptions of patients with chronic pain

2009 ◽  
Vol 29 (4) ◽  
pp. 162-168
Author(s):  
AL Dewar ◽  
K Gregg ◽  
MI White ◽  
J Lander
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Health Care System ◽  
Health Care Professionals ◽  
Primary Care Physicians ◽  
Treatment Compliance ◽  
Care Utilization ◽  
Semistructured Interviews ◽  
The Individual ◽  
Care System

A new framework is needed for patients with chronic pain and their primary care physicians that acknowledges the individual’s experiences and provides evidence-informed education and better linkages to community-based resources. This study describes the experience of 19 chronic-pain sufferers who seek relief via the health care system. Their experiences were recorded through in-depth semistructured interviews and analyzed through qualitative methods. The participants reported early optimism, then disillusionment, and finally acceptance of living with chronic pain. Both individuals with chronic pain and their health care professionals need evidence-informed resources and information on best practices to assist them to manage pain. Empathetic communication between health care professionals and individuals with chronic pain is crucial because insensitive communication negatively affects the individual, reduces treatment compliance and increases health care utilization.

Association of chronic pain with comorbidities and health care utilization

Pain ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Heather E. Foley ◽  
John C. Knight ◽  
Michelle Ploughman ◽  
Shabnam Asghari ◽  
Richard Audas
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Health Care Utilization ◽  
Care Utilization

scholarly journals Gender Differences in Health Care Utilization Among Veterans with Chronic Pain

2007 ◽  
Vol 22 (2) ◽  
pp. 228-233 ◽  
Author(s):  
Suneet Kaur ◽  
Karen M. Stechuchak ◽  
Cynthia J. Coffman ◽  
Kelli D. Allen ◽  
Lori A. Bastian
Keyword(s):  
Health Care ◽  
Gender Differences ◽  
Chronic Pain ◽  
Health Care Utilization ◽  
Care Utilization

scholarly journals Prevalence and Determinants of Pain and Pain-Related Disability in Urban and Rural Settings in Southeastern Ontario

2006 ◽  
Vol 11 (4) ◽  
pp. 225-233 ◽  
Author(s):  
Dean A Tripp ◽  
Elizabeth G VanDenKerkhof ◽  
Margo McAlister
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Health Status ◽  
Health Care Utilization ◽  
Pain Intensity ◽  
Pain Interference ◽  
Urban Region ◽  
Care Utilization ◽  
The Past ◽  
Pain Prevalence

BACKGROUND: Canadian chronic pain prevalence estimates range from 11% to 66%, are affected by sampling and measurement bias, and largely represent urban settings.OBJECTIVES: To estimate chronic pain prevalence and factors associated with pain in southeastern Ontario, a region with a larger rural than urban residence.METHODS: A systematic sampling with a random start was used to contact households. A telephone-administered questionnaire using the Graded Chronic Pain Scale, with questions on health care and medication use, health status, depression and demographics, was administered to consenting adults (18 to 94 years of age; mean age 50.2±16.6 years).RESULTS: The response rate was 49% (1067 of 2167), with 76% reporting some pain over the past six months. Low pain intensity with low pain interference prevalence was 34% (grade I), high pain intensity with low pain interference was 26% (grade II), and high pain intensity with high pain interference was 17% (grades III and IV). Of those reporting pain, 49% reported chronic pain (ie, pain for a minimum of 90 days over the past six months) representing 37% of the sample. Being female, unmarried, lower income, poorer self-reported health status and rural residence were associated with increasing pain. Once depression was considered in this pain analysis, residence was no longer significant. Lower rates of health care utilization were reported by rural residents. In those reporting the highest pain grades, poor health, greater medication and health care use, depression and more pain sites were associated with higher odds for pain-related disability.CONCLUSION: There is an elevated prevalence of pain in this almost equally split rural/urban region. Further examination of health care utilization and depression is suggested in chronic pain prevalence research.

Efficient and Effective Models for Integrating Advanced Practice Professionals into Oncology Practice

2013 ◽  
pp. e377-e379
Author(s):  
Lawrence N. Shulman
Keyword(s):  
Health Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Models Of Care ◽  
Advanced Practice ◽  
Practice Style ◽  
Oncology Care ◽  
Oncology Practice ◽  
Effective Models

Advanced practice professionals (APP), primarily nurse practitioners and physician assistants, are increasingly being integrated into oncology practices. The reasons are numerous, and models of care options are numerous as well. Models of care have developed without much forethought and are often the result of the relative interests of the physician, the APP, and the mutual “comfort” of practice style. The increasing complexity of oncology care, the pressures of the health care crisis and health care reform mean that it is necessary that we examine models of collaborative care in terms of both quality of care and productivity.

Health care utilization among long-term cancer survivors.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 22-22 ◽  
Author(s):  
Emily Jo Rajotte ◽  
Leslie Heron ◽  
Karen Leslie Syrjala ◽  
Kevin Scott Baker
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Population ◽  
Cancer Survivors ◽  
Care Physician ◽  
Shared Care ◽  
Care Utilization ◽  
Care Model ◽  
Clinic Appointment ◽  
Shared Care Model

22 Background: Survivors of adult cancer face lifetime health risks that are dependent on their cancer, cancer treatment exposures, comorbid health conditions, and lifestyle behaviors. A shared care model, including planned and formal transition of the cancer survivor from the oncologist to the primary care physician needs to be established to ensure appropriate care. Methods: As a LIVESTRONG Survivorship Center of Excellence Network member, the Survivorship Program at the Fred Hutchinson Cancer Research Center has established an outpatient clinic at the Seattle Cancer Care Alliance to meet the clinical needs of cancer survivors. Before their survivorship-focused clinic appointment, adult cancer survivors are asked to complete a comprehensive survey that includes questions on health care utilization. Results: Between August 2013 to December 2014, 142 clinic patients completed the survey. They were 70.4% female, mean age 48 years (SD 16.3, range 22-83) and 21.1% breast cancer, 30.2% leukemia/lymphoma, and 17.6% reproductive cancer survivors. Patients were a mean of 7.8 years (SD 9.5, range 0-43) from their cancer diagnosis at the time of clinic appointment. 70.4% reported receiving oncology care and 87.3% primary care within the 12 months before their survivorship visit. Forty percent reported more than 12 clinic visits in the past year in which they saw a physician, nurse practitioner or physician assistant compared with 6.5 clinic visits in the general population based on CDC, National Health Care Survey reference data. 41.5% had one or more visits to a hospital emergency or urgent care facility within the last year, compared with 39.4% in the CDC NHCS survey. Conclusions: Cancer survivors seen in a Survivorship Clinic utilize healthcare at a much higher rate than the general population. A shared-care model for cancer survivors, including a delineation of roles and specific points of communication, between the oncologist and the primary care physician may help address issues surrounding over-utilization. A cancer treatment summary and a survivorship care plan may be valuable tools to facilitate this shared care approach.

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