Linda Garufi Clark1, Carole C Upshur. 1. Department of Family Medicine and Community Health, University of Massachusetts Medical School, Boston, USA. Linda.ClarkFHCW@umassmed.edu
Abstract
PURPOSE: To determine family practice provider views of how to improve chronic nonmalignant pain (CNMP) management in primary care. METHODS: Modified Delphi group process with providers randomly selected from 6 community practice sites: 3 federally qualified community health centers, 1 rural health center, and 2 hospital-owned practices. Providers gave structured written feedback in response to a report of provider and patient concerns about the quality of CNMP in their practice sites and participated in a facilitated discussion in 1 of 3 group meetings. RESULTS: 54% participation (n=14) of family physicians, 6 to 30 years out of residency, identified 4 major themes for improvement of CNMP treatment: (1) the need for provider practice guidelines; (2) changes in the monthly opioid prescription refill process; (3) provision of self-management support and access to alternative treatments for patients; and (4) the use of a nurse care manager. CONCLUSIONS: Family physicians identified multiple components of practice that would improve both provider and patient experiences during and outcomes of CNMP management. Recommendations lend themselves to consideration of CNMP as a chronic illness and use of the Chronic Care Model as an appropriate framework for quality improvement.
PURPOSE: To determine family practice provider views of how to improve chronic nonmalignant pain (CNMP) management in primary care. METHODS: Modified Delphi group process with providers randomly selected from 6 community practice sites: 3 federally qualified community health centers, 1 rural health center, and 2 hospital-owned practices. Providers gave structured written feedback in response to a report of provider and patient concerns about the quality of CNMP in their practice sites and participated in a facilitated discussion in 1 of 3 group meetings. RESULTS: 54% participation (n=14) of family physicians, 6 to 30 years out of residency, identified 4 major themes for improvement of CNMP treatment: (1) the need for provider practice guidelines; (2) changes in the monthly opioid prescription refill process; (3) provision of self-management support and access to alternative treatments for patients; and (4) the use of a nurse care manager. CONCLUSIONS: Family physicians identified multiple components of practice that would improve both provider and patient experiences during and outcomes of CNMP management. Recommendations lend themselves to consideration of CNMP as a chronic illness and use of the Chronic Care Model as an appropriate framework for quality improvement.
Authors: Declan T Barry; Kevin S Irwin; Emlyn S Jones; William C Becker; Jeanette M Tetrault; Lynn E Sullivan; Helena Hansen; Patrick G O'Connor; Richard S Schottenfeld; David A Fiellin Journal: J Pain Date: 2010-06-02 Impact factor: 5.820
Authors: Roberto Cardarelli; William Elder; Sarah Weatherford; Karen L Roper; Dana King; Charlotte Workman; Kathryn Stewart; Chong Kim; William Betz Journal: J Interprof Care Date: 2018-03-30 Impact factor: 2.338