Dataset Information

Meeting high-risk patient pain care needs through intensive primary care: a secondary analysis.

ABSTRACT:

Objective

Chronic pain disproportionately affects medically and psychosocially complex patients, many of whom are at high risk of hospitalisation. Pain prevalence among high-risk patients, however, is unknown, and pain is seldom a focus for improving high-risk patient outcomes. Our objective is to (1) evaluate pain frequency in a high-risk patient population and (2) identify intensive management (IM) programme features that patients and providers perceive as important for promoting patient-centred pain care within primary care (PC)-based IM.

Design

Secondary observational analysis of quantitative and qualitative evaluation data from a multisite randomised PC-based IM programme for high-risk patients.

Setting

Five integrated local Veterans Affairs (VA) healthcare systems within distinct VA administrative regions.

Participants

Staff and high-risk PC patients in the VA.

Intervention

A multisite randomised PC-based IM programme for high-risk patients.

Outcome measures

(a) Pain prevalence based on VA electronic administrative data and (b) transcripts of interviews with IM staff and patients that mentioned pain.

Results

Most (70%, 2593/3723) high-risk patients had at least moderate pain. Over one-third (38%, 40/104) of the interviewees mentioned pain or pain care. There were 89 pain-related comments addressing IM impacts on pain care within the 40 interview transcripts. Patient-identified themes were that IM improved communication and responsiveness to pain. PC provider-identified themes were that IM improved workload and access to expertise. IM team member-identified themes were that IM improved pain care coordination, facilitated non-opioid pain management options and mitigated provider compassion fatigue. No negative IM impacts on pain care were mentioned.

Conclusions

Pain is common among high-risk patients. Future IM evaluations should consider including a focus on pain and pain care, with attention to impacts on patients, PC providers and IM teams.

SUBMITTER: Giannitrapani KF

PROVIDER: S-EPMC10773401 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Publications

Meeting high-risk patient pain care needs through intensive primary care: a secondary analysis.

Giannitrapani Karleen F KF Holliday Jesse R JR McCaa Matthew D MD Stockdale Susan S Bergman Alicia A AA Katz Marian L ML Zulman Donna M DM Rubenstein Lisa V LV Chang Evelyn T ET

BMJ open 20240102 1

<h4>Objective</h4>Chronic pain disproportionately affects medically and psychosocially complex patients, many of whom are at high risk of hospitalisation. Pain prevalence among high-risk patients, however, is unknown, and pain is seldom a focus for improving high-risk patient outcomes. Our objective is to (1) evaluate pain frequency in a high-risk patient population and (2) identify intensive management (IM) programme features that patients and providers perceive as important for promoting patie ...[more]

PMID: 38167288

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Dataset Information

Meeting high-risk patient pain care needs through intensive primary care: a secondary analysis.

Objective

Design

Setting

Participants

Intervention

Outcome measures

Results

Conclusions

Publications

Meeting high-risk patient pain care needs through intensive primary care: a secondary analysis.

Similar Datasets

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