Background & Aims
Interdisciplinary team-based care for patients with persistent pain had its early roots in Seattle, Washington, at the University of Washington more than 50 yrs ago led by leaders in the nascent field of pain medicine, including Drs. Bonica, Fordyce, Loeser and others helping to shape team-based BioPsychoSocially-based (BPS) care. A recent shift back towards a BPS whole person approach to pain management, and an evolving knowledge of pain processing, behavioral changes, central sensitization, and technologies that help ensure improved patient compliance and engagement (i.e. Apps, web-based content, and telehealth) has provided opportunities for healthcare systems and traditional “pain clinics” greater opportunity to incorporate these programs into their model of care and providing truly “comprehensive” patient-centered care. The poster reviews therapeutic clinical focus (PT/OT/Beh Med/Pain Ed) of 4-wk program (52 patients), billing, reimbursement, payer issues, & patient experience.
Methods
1.Review pre- and post-outcomes of a cohort of 52 patients completing the 4-week, structured functional restoration program (SFRP) (i.e. GAD-7, PHQ-9, Pain Catastrophizing Scale, PROMIS-29), data collected as part of a quality improvement project.
2. Summarize programmatic structure of functional restoration program in the US that provided care for a range of patients, including privately insured, government programs sponsored, and injured workers.
3. Review program structure and disciplines in the Providence Swedish SFRP including physical and occupational therapy, behavioral medicine, relaxation training, pain education, tai chi, and medical management as well as therapy charges and programs costs and reimbursement.
4. Patient tools & Resources. Provide examples of Apps and other web-based tools that have been integrated into patient care programs to help improve patient compliance and engagement.
5. Patient Experience: Share patient experiences with the treatment program.
Results
Of 52 patients that completed the 4-week, 3 half-day per week, SFRP, demonstrated improvements across all domains at discharge, including pain/VAS (pre 6.15/post 5.2); ODI (pre 41%/post 37%); GAD-7 (pre 7.0/post 4.7); PHQ-9(pre 9.0/post 6.7); CPAQ Activity (pre 34.4/39.9[improved activity]); TSK (pre 37.7/post 32.9); PCS-Rumination (pre8.6/post 5.2): PCS-Magnification (pre 4.6/3.2); PCS-Helplessness (pre11.4/post 6.0), PCS-total (pre 24.6/post 14.4); and 6-minute walk test (meters) (pre 495/ post 698).
VAS = Visual Analogue Scale; ODI: Oswestry Disability Index; GAD-7= General Anxiety Disorder-7; PHQ-9 = Patient Health Questionnaire-9; CPAQ = Chronic Pain Acceptance Questionnaire; TSK = Tampa Kinesiophobia Scale; PCS = Pain Catastrophizing Scale
Conclusions
In celebrating of 50 years of the IASP, promotion of interdisciplinary pain programs today is even more important given the growing need to better integrate biopsychosocially-based care into current pain clinic treatment models. The structured interdisciplinary pain program at Providence Swedish in Seattle, WA, USA, continues to support the vision and mission of early pioneers in the field of medicine in Seattle, Washington and the world. Besides improvement across multiple patient domains, this programs show how structured program can be integrated into a classic pain clinic model that includes interventional therapies, medical management, and addiction services, providing a true “comprehensive” pain center that meets the needs of a large hospital system network of care.
The poster reviews a functional restoration pain program, its outcomes, program structure, billing & coding, patient tools and resources that help to improve compliance and patient engagement. We celebrate IASP!
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Presenting Author
Steven Stanos
Poster Authors
Steven Stanos
DO
Providence Swedish, Seattle, Washington, USA
Lead Author
Wilson Chang
MD
Providence Swedish Swedish Pain Services
Lead Author
Daisy Aceves
PhD
Providence Swedish Swedish Pain Services
Lead Author
Sonja Braasch
OT
Providence Swedish Swedish Pain Services
Lead Author
Laura Broudy
DPT
Providence Swedish Swedish Pain Services
Lead Author
Ambi Brynell
DPT
Providence Swedish Swedish Pain Services
Lead Author
Paulomi Campbell
PhD
Providence Swedish Swedish Pain Services
Lead Author
Cheyenne Dixon
OT
Providence Swedish Swedish Pain Services
Lead Author
Nate Hadley
DPT
Providence Swedish Swedish Pain Services
Lead Author
Becca Taylor
RN
Providence Swedish Swedish Pain Services
Lead Author
Topics
- History