Background & Aims

Given its multicausality, research studies have insisted on the necessity of an interdisciplinary approach to pain. The Pain Unit of Hospital Banco de Seguros del Estado (HBSE) has developed a pain program which meets these requirements. This program was audited by CARF (Commission on Accreditation of Rehabilitation facilities), achieving its international accreditation in quality (08/2022). This work emphasizes the methodology of an interdisciplinary clinical approach in pain, which must have clear objectives, golds and indicators for a continuous evaluation of results. The focus of clinical intervention is the person with pain, taking into account their biopsychosocial complexity. We highlight the importance of the interdisciplinary clinical interview, the construction of a comprehensive clinical history (CH )and the development of “tailored” therapeutic strategies with emphasis on physical psychological rehabilitation and the development of strategies to self-manage the pain symptom

Methods

Qualitative description of the interdisciplinary approach methodology – unique in the country – of the Rehabilitation – Pain Program of HBSE, Montevideo, Uruguay.

Results

The outpatient HBSE Pain Program is the result of an iterative learning process that culminates with the consolidation of an innovative work methodology. There is agreement upon the conceptualization of study object (pain), formation of the interdisciplinary team and its way of functioning. Fundamental characteristics of the program: interdisciplinary clinical interview, construction of a comprehensive CH, application of functional and psychometric evaluation instruments, preparation of situational, nosological and systemic diagnoses, comprehensive therapeutic strategies and assessment of results through measurable indicators, such as: global functionality, pain intensity, drug use, pain self-management, activity (psychometric scales), services experience and CH audit will be shown. In the last semester of 2023, 92% were satisfied with the program, 43 % had a pain intensity reduction of 2 or more points on the EVA scale and 77 % with chronic pain improved their overall functionality.

Conclusions

From our personal experience, an interdisciplinary approach is more suited for chronic pain. The results obtained are close to or reach the goals defined in the program. An adequate patient-team relationship is developed that allows addressing all the medical and psychosocial aspects involved is developed. It becomes possible to address sensitive aspects and topics such as traumatic situations suffered, bereavements, existing psychiatric pathologies, work and/or family conflicts, which are clearly linked to chronic pain both in its genesis and in its perpetuation. It also allows for an adequate selection of people who can benefit from interventional therapeutic procedures. Empowerment of the person who consults is achieved by being included and actively participating in the care process, taking into account cultural aspects and diversity. All this, results in better symptom control and a high level of satisfaction.

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Presenting Author

Maria Jose Montes

Poster Authors

Gustavo Quinteros

MD

Hospital BSE, Uruguay

Lead Author

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