Flynn Diane M, Cook Karon, Kallen Michael, Buckenmaier Chester, Weickum Ricke, Collins Teresa, Johnson Ashley, Morgan Dawn, Galloway Kevin, Joltes Kristin
Department of Pain Management, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431.
Department of Medical Social Sciences, Feinstein School of Medicine, Northwestern University, 633 North Street Clair, 19th Floor, Chicago, IL 60611.
Mil Med. 2017 Mar;182(S1):167-174. doi: 10.7205/MILMED-D-16-00212.
The U.S. Army Comprehensive Pain Management Campaign Plan was launched in 2010 to improve pain outcomes in military populations. Interdisciplinary Pain Management Centers (IPMCs) were established at every Army medical center, each offering a robust array of treatment options including conventional and complementary and integrative medicine (CIM) pain management therapies. The Pain Assessment Screening Tool and Outcomes Registry (PASTOR) was developed to assess and track biopsychosocial aspects of pain management and to identify best treatment practices.
During a 10-month pilot test of PASTOR at one Army IPMC, active duty patients completed PASTOR at baseline and at significant junctures during their therapeutic course.
322 IPMC patients completed baseline and follow-up PASTOR assessments. The PASTOR outcomes were analyzed for patients who completed a 3- to 6-week CIM program, a 3-week functional restoration program, or both. For most PASTOR domains, a greater proportion of patients who completed both programs reported important improvement compared with patients who completed either program alone.
This pilot test demonstrated the utility of using PASTOR in a military IPMC to track biopsychosocial treatment outcomes. These preliminary data will inform future comparative effectiveness analyses of pain therapies among military and veteran populations.
美国陆军综合疼痛管理运动计划于2010年启动，旨在改善军人的疼痛状况。每个陆军医疗中心都设立了跨学科疼痛管理中心（IPMC），每个中心都提供一系列丰富的治疗选择，包括传统以及补充和整合医学（CIM）疼痛管理疗法。开发了疼痛评估筛查工具和结果登记系统（PASTOR），以评估和跟踪疼痛管理的生物心理社会方面，并确定最佳治疗方法。
在一个陆军IPMC对PASTOR进行为期10个月的试点测试期间，现役患者在基线时以及治疗过程中的重要节点完成了PASTOR评估。
322名IPMC患者完成了基线和随访PASTOR评估。对完成3至6周CIM计划、3周功能恢复计划或两者的患者的PASTOR结果进行了分析。对于大多数PASTOR领域，与仅完成其中一个计划的患者相比，完成两个计划的患者中有更大比例报告有显著改善。
这项试点测试证明了在军事IPMC中使用PASTOR跟踪生物心理社会治疗结果的效用。这些初步数据将为未来对军人和退伍军人人群疼痛疗法的比较有效性分析提供参考。
