Background & Aims

Pain is the most common reason for seeking healthcare. Pharmacological treatments alone may not effectively manage pain and utilizing nonpharmacologic and integrative options provide a more comprehensive patient focused approach. Hospital programs promoting such approaches exist, but there is minimal published data on program outcomes in socioeconomically disadvantaged populations who have limited resources and may have difficulty incorporating nonpharmacologic pain management modalities. Additionally, despite an increase in patients’ preferences for these types of approaches, most health care professionals have minimal training or time to educate patients on nonpharmacologic pain management options. To address this need, a pain coach patient education program providing customized education sessions on 18 topics and integrative pain management toolkits for home use was initiated in a safety-net hospital system serving a disadvantaged population.

Methods

This model pain education program and follow up phone surveys were registered with the affiliated university’s Quality Improvement Project Registry. Patients ? 14 years of age with pain and capacity to participate in coaching sessions were eligible. Exclusion criteria included cognitive impairment, suicidal or violent behavior, incarceration, severe uncontrolled pain, or critically illness. Services were provided in the emergency department (ED), inpatient, and outpatient settings. Patients were asked to complete surveys one-month after their coaching session to assess toolkit home utilization, adherence, and perceived program value. Survey responses from patients completing the survey between November 2021 to November 2023, along with demographic data, area deprivation index (ADI) percentile, pain type, and type of education and toolkit items provided during coaching sessions were analyzed. Descriptive statistics were performed using R statistical software.

Results

During the two-year study period, the program coached 1,835 patients and 442 (24%) completed the survey. Of those surveyed, the average age was 50 years (SD=16.1); most were female (69%), Black (57%), Non-Hispanic/Latino (98%), living in socioeconomic disadvantage (ADI M=76, SD=19.1], range 16-100), presenting for acute pain (53%), and coached in the ED setting (56%). Coaching sessions most often utilized hot/cold therapy gel packs (96%), 4 flat tires stress ball pain analogy (95%), and aromatherapy (94%). Most patients (88%) reported using the toolkit items received during their session at least once in the previous 30 days. Aromatherapy (53%), hot/cold therapy (48%) and stress ball pain analogy (37%) were the most common items used at home. Many reported using items daily (34%) or weekly (40%). Most (77%) reported their session as very helpful or helpful on a 5-point Likert scale (M=4.49, SD=0.84) and 83% would recommend the program to others.

Conclusions

A model pain coach education program and customized toolkit for managing pain at home benefits patients’ one-month after a single-coaching session including a high-minority, disadvantaged pain population with high ADI scores. At one month evaluation, most participants reported consistent home use of toolkit and educational items. Future plans include analysis of qualitative statements and assessment of program effects on other outcomes such as hospital re-admission and ED recidivism, opioid use, and cost-effectiveness. All program materials, including a pain coach program guide, educational brochures, and patient workbook are available as free access online for adaptation to other programs. This program offers patients and healthcare professionals a new model for nonopioid, integrative pain management alternatives supporting patient home management and efficacy.

References

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Presenting Author

Megan E. Curtis

Poster Authors

Megan Curtis Gonzalez

PhD

University of Florida College of Medicine - Jacksonville

Lead Author

Sophia Sheikh

MD

University of Florida College of Medicine - Jacksonville

Lead Author

Magda Montague

MPH

University of Florida College of Medicine – Jacksonville

Lead Author

Michelle Lott

BSH

University of Florida College of Medicine – Jacksonville

Lead Author

Nolan Menze

BSH

University of Florida College of Medicine – Jacksonville

Lead Author

Leighton Cleveland

BSH

University of Florida College of Medicine – Jacksonville

Lead Author

Katelyn Perl

MS

University of Florida College of Medicine – Jacksonville

Lead Author

Amy Crisp

PhD

University of Florida College of Medicine – Jacksonville

Lead Author

Robin Moorman Li

PharmD

University of Florida College of Medicine – Jacksonville

Lead Author

Phyllis Hendry

MD

University of Florida College of Medicine – Jacksonville

Lead Author

Topics

  • Education