Background & Aims
4PCP (The Primary Practice Practitioner Program for Chronic Pain) ECHO (Extension of Community Health Outcomes) launched at Virginia Commonwealth University in March 2023, as part of the 4PCP curriculum that trains medical practitioners, behaviorists and PT’s to work together in chronic pain management. 4PCP ECHO, an interactive 1-hour webinar, consists of a 20-minute presentation on a biobehavioral aspect of chronic pain management, followed by de-identified patient case discussions focusing on the challenges in managing chronic pain. The ECHO session is intended to reinforce the information learned in the 4PCP curriculum, which teaches practitioners (1) how to use the stages of readiness (2) how to speak effectively with patients and de-escalate tense conversations and (3) how to apply the bio-behavioral paradigm to conceptualize chronic pain as a brain disorder and (4) how to create a multi-disciplinary team for patient centered care.
Methods
4PCP ECHO is a webinar that is open to practitioners across the world. We meet monthly for 1 hour; each session consists of a didactic presentation about how to manage chronic pain, followed by a de-identified patient discussion on how to help both patient and practitioner move forward with existing challenges. The 4PCP course instructors select presenters are intentional in ensuring they are teaching bio-behavioral approaches on how to manage chronic pain. All practitioners who join the course are eligible to claim 1 hour of Continuing Education Credit. Participants complete an anonymous evaluation. Currently, we advertise to our course attendees, staff at the Children’s Hospital of Richmond and VCU Health, and partners at Bozeman health. We reviewed our attendance records for each of the monthly sessions since the start of the ECHO to quantify: who participated, how they learned about the program, which parts were most impactful, and how they planned to change their practice.
Results
Since 4PCP ECHO launched in March 2023, we have had 76 unique participants. Of the participants who have joined so far, 26 participants have joined more than one session. The conference began with only 5 participants in March and increased to 34 in November 2023. A total of 27 doctors (MD, DO) have attended, 11 advance practitioners (PA, NP), 5 PhD, 9 nurses (RN, BSN, LPN), 10 physical therapists (PT, OT, RRT, DPT), 5 social workers (LCP, LCSW, MSW), 1 Bachelor of Science, 1 Pharmacist, and 3 participants with unknown credentials. We have a total of 38 evaluations submitted anonymously, 16 heard about 4PCP ECHO through email flyers, 13 from the 4PCP course, 6 through colleagues, and 4 from other methods not explained. Twenty five participants responded regarding how their practice would change:(1) how they make referrals to other providers, (2) a better understanding of the topic discussed, (3) incorporating the discussed bio-behavioral approach , and using new medication options.
Conclusions
The 4PCP-ECHO conference is gaining some momentum with increasing attendance and many repeat participants. The diversity of participants suggests that we are reaching the disciplines that best work together in the management of pain. There are opportunities in allowing for more open conversation and normalizing the difficulties of pain management in general practice. There is also an opportunity to better capture repeat participants. We also aim capture a wider audience in other states and around the world to gain a variety of perspectives on chronic pain management. Overall, we want to encourage more practitioners to help patients have realistic expectations of managing chronic pain using a bio-behavioral approach and a interdisciplinary team to reduce burn out from the challenges in managing the complexities of the symptoms of this diagnosis.
References
None.