Ryan S, Packham J C, T Dawes P, Jordan K P
Staffordshire Rheumatology Centre, Haywood Hospital, High Lane, Burslem, Stoke on Trent, UK.
Musculoskeletal Care. 2012 Dec;10(4):196-201. doi: 10.1002/msc.1018. Epub 2012 Jun 13.
To determine whether a nurse-led chronic musculoskeletal pain clinic for fibromyalgia patients can reduce utilization of healthcare services.
People with fibromyalgia often consult multiple specialities due to the vast nature of their symptoms but receive little or no help in managing their symptoms.
A retrospective evaluation of a nurse consultant-led chronic pain management clinic.
The frequency of hospital attendances in the five years before and three years after pain clinic attendance was evaluated. General practitioner (GP) attendances in the 12-month period before and after pain clinic attendance were compared with attendances for two groups of patients from an established GP cohort: (i) patients referred to rheumatology new patient clinics and (ii) all patients with fibromyalgia referred to any hospital new patient clinic.
In the three years following attendance at the pain clinic, the mean number of hospital appointments fell significantly from 2.8 to 1.4 per annum (p < 0.001). The mean reduction seen in hospital clinic attendances in the first year (0.8/annum) improved in the second (1.2/annum) and third (2.1/annum) years. Seventy-eight per cent of pain clinic patients reduced their visits to their GP in the 12 months following treatment in the pain service, compared with 53% of patients referred to rheumatology clinics and 46% of patients with fibromyalgia.
A nurse-led chronic pain clinic for fibromyalgia patients can have a positive impact on primary and secondary healthcare utilization.
Having a designated nurse-led pain clinic can enable patients to access the appropriate service at an earlier stage in their condition and receive the support needed to manage the impact of their pain.
确定由护士主导的纤维肌痛患者慢性肌肉骨骼疼痛诊所是否能减少医疗服务的使用。
纤维肌痛患者由于症状广泛，常咨询多个专科，但在症状管理方面得到的帮助很少或没有帮助。
对由护士顾问主导的慢性疼痛管理诊所进行回顾性评估。
评估疼痛诊所就诊前五年和就诊后三年的住院频率。将疼痛诊所就诊前和就诊后12个月内全科医生（GP）的就诊次数与来自已建立的全科医生队列的两组患者的就诊次数进行比较：（i）转诊至风湿病新患者诊所的患者；（ii）所有转诊至任何医院新患者诊所的纤维肌痛患者。
在疼痛诊所就诊后的三年中，每年的平均医院预约次数从2.8次显著降至1.4次（p < 0.001）。第一年（每年0.8次）医院门诊就诊次数的平均减少量在第二年（每年1.2次）和第三年（每年2.次）有所改善。78%的疼痛诊所患者在疼痛服务治疗后的12个月内减少了对全科医生的就诊，相比之下，转诊至风湿病诊所的患者为53%，纤维肌痛患者为46%。
由护士主导的纤维肌痛患者慢性疼痛诊所可对初级和二级医疗服务的使用产生积极影响。
设立由护士主导的疼痛诊所可使患者在病情早期就能获得适当的服务，并获得管理疼痛影响所需的支持。
