Literature DB >> 19282742

Spine and pain clinics serving North Carolina patients with back and neck pain: what do they do, and are they multidisciplinary?

Liana D Castel1, Janet K Freburger, George M Holmes, Rachael P Scheinman, Anne M Jackman, Timothy S Carey.   

Abstract

STUDY
DESIGN: Cross-sectional survey.
OBJECTIVE: Our primary objective was to describe spine and pain clinics serving North Carolina residents with respect to organizational characteristics. Our secondary objective was to assess the multidisciplinary nature of the clinics surveyed. SUMMARY OF BACKGROUND DATA: Pain clinics have become common in the United States, and patients with chronic back pain have increasingly been seeking services at these clinics. Little is known about the organizational characteristics of spine and pain clinics.
METHODS: We identified and surveyed spine and pain clinics serving North Carolina residents with chronic back and neck pain. Practice managers at 46 clinics completed a 20-minute questionnaire about the characteristics of their clinic, including providers on staff and services offered. Descriptive and exploratory analyses were conducted to summarize the data. Several variables were constructed to assess the multidisciplinary nature of the clinics.
RESULTS: The response rate was 75%. There was marked heterogeneity among the clinics surveyed. Fifty-nine percent of practices were free-standing (n = 27) and 61% were physician-owned (n = 28). Twenty-five clinics (54%) had an anesthesiologist. Other common physician providers were physiatrists and surgeons. Less than one third of sites had mental health providers (n = 12; 26%); only 26% employed physical therapists. Seventy-six percent of sites offered epidural injections, 74% long-term narcotic prescriptions, and 67% antidepressants. The majority of clinics (30 of 33) prescribing narcotics provided monitoring of therapy using periodic urine toxicology testing. Forty-eight percent of sites (n = 22) offered exercise instruction. Few clinics were multidisciplinary in nature. Only 3 (7%) met the criteria of having a medical physician, registered nurse, physical therapist, and mental health specialist.
CONCLUSION: Clinics varied widely in their organizational characteristics, including providers and scope of services available. Few clinics were multidisciplinary in nature. This information should be used to determine how pain clinics can better serve patients and improve outcomes.

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Mesh:

Year:  2009        PMID: 19282742      PMCID: PMC2757449          DOI: 10.1097/BRS.0b013e31817b8fa2

Source DB:  PubMed          Journal:  Spine (Phila Pa 1976)        ISSN: 0362-2436            Impact factor:   3.468


  18 in total

1.  Back pain exacerbations and lost productive time costs in United States workers.

Authors:  Judith A Ricci; Walter F Stewart; Elsbeth Chee; Carol Leotta; Kathleen Foley; Marc C Hochberg
Journal:  Spine (Phila Pa 1976)       Date:  2006-12-15       Impact factor: 3.468

Review 2.  Epidural steroids in the management of chronic spinal pain: a systematic review.

Authors:  Salahadin Abdi; Sukdeb Datta; Andrea M Trescot; David M Schultz; Rajive Adlaka; Sairam L Atluri; Howard S Smith; Laxmaiah Manchikanti
Journal:  Pain Physician       Date:  2007-01       Impact factor: 4.965

3.  Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain.

Authors:  Mark V Boswell; Andrea M Trescot; Sukdeb Datta; David M Schultz; Hans C Hansen; Salahadin Abdi; Nalini Sehgal; Rinoo V Shah; Vijay Singh; Ramsin M Benyamin; Vikram B Patel; Ricardo M Buenaventura; James D Colson; Harold J Cordner; Richard S Epter; Joseph F Jasper; Elmer E Dunbar; Sairam L Atluri; Richard C Bowman; Timothy R Deer; John R Swicegood; Peter S Staats; Howard S Smith; Allen W Burton; David S Kloth; James Giordano; Laxmaiah Manchikanti
Journal:  Pain Physician       Date:  2007-01       Impact factor: 4.965

Review 4.  Multidisciplinary rehabilitation for chronic low back pain: systematic review.

Authors:  J Guzmán; R Esmail; K Karjalainen; A Malmivaara; E Irvin; C Bombardier
Journal:  BMJ       Date:  2001-06-23

5.  Audit in pain clinics: changing the management of low-back and nerve-damage pain.

Authors:  H T Davies; I K Crombie; W A Macrae; K M Rogers; J E Charlton
Journal:  Anaesthesia       Date:  1996-07       Impact factor: 6.955

6.  Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002.

Authors:  Richard A Deyo; Sohail K Mirza; Brook I Martin
Journal:  Spine (Phila Pa 1976)       Date:  2006-11-01       Impact factor: 3.468

Review 7.  Pain clinics.

Authors:  J Crook; E Tunks
Journal:  Rheum Dis Clin North Am       Date:  1996-08       Impact factor: 2.670

8.  The experience of chronic back pain: accounts of loss in those seeking help from pain clinics.

Authors:  Jan Walker; Beatrice Sofaer; Immy Holloway
Journal:  Eur J Pain       Date:  2005-04-18       Impact factor: 3.931

Review 9.  Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline.

Authors:  Roger Chou; Laurie Hoyt Huffman
Journal:  Ann Intern Med       Date:  2007-10-02       Impact factor: 25.391

10.  Predictors of opioid misuse in patients with chronic pain: a prospective cohort study.

Authors:  Timothy J Ives; Paul R Chelminski; Catherine A Hammett-Stabler; Robert M Malone; J Stephen Perhac; Nicholas M Potisek; Betsy Bryant Shilliday; Darren A DeWalt; Michael P Pignone
Journal:  BMC Health Serv Res       Date:  2006-04-04       Impact factor: 2.655

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  5 in total

1.  Physical therapy for chronic low back pain in North Carolina: overuse, underuse, or misuse?

Authors:  Janet K Freburger; Timothy S Carey; George M Holmes
Journal:  Phys Ther       Date:  2011-02-17

2.  Immediate effect of pain neuroscience education for recent onset low back pain: an exploratory single arm trial.

Authors:  Adriaan Louw; Kevin Farrell; Breanna Choffin; Brooke Foster; Grace Lunde; Michelle Snodgrass; Robert Sweet; Matthew Weitzel; Rebecca Wilder; Emilio J Puentedura
Journal:  J Man Manip Ther       Date:  2019-06-04

3.  Lumbar fusion surgery for degenerative conditions is associated with significant resource and narcotic use 2 years postoperatively in the commercially insured: a medical and pharmacy claims study.

Authors:  David E Mino; James E Munterich; Liana D Castel
Journal:  J Spine Surg       Date:  2017-06

Review 4.  Pain clinic definitions in the medical literature and U.S. state laws: an integrative systematic review and comparison.

Authors:  Barbara Andraka-Christou; Joshua B Rager; Brittany Brown-Podgorski; Ross D Silverman; Dennis P Watson
Journal:  Subst Abuse Treat Prev Policy       Date:  2018-05-22

Review 5.  Systematic Review of Multidisciplinary Chronic Pain Treatment Facilities.

Authors:  Samantha R Fashler; Lynn K Cooper; Eric D Oosenbrug; Lindsay C Burns; Shima Razavi; Lauren Goldberg; Joel Katz
Journal:  Pain Res Manag       Date:  2016-03-29       Impact factor: 3.037

  5 in total

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