Zhao Jane, Salemohamed Naima, Stinson Jennifer, Carlin Leslie, Seto Emily, Webster Fiona, Furlan Andrea D
ECHO Ontario Chronic Pain and Opioid Stewardship, Toronto Rehabilitation Institute, Ontario, Toronto, Canada.
Institute of Health Policy, Management, and Evaluation, University of Toronto, Ontario, Toronto, Canada.
Can J Pain. 2020 Jun 1;4(1):111-121. doi: 10.1080/24740527.2020.1749003.
Chronic pain affects one in five Canadians. Frontline health care providers (HCPs) manage the majority of patients with chronic pain yet receive minimal training to do so. The Extension for Community Healthcare Outcomes (ECHO) model™ is an education intervention aimed at HCPs (not patients) to support and improve care in underserviced communities. ECHO Ontario Chronic Pain and Opioid Stewardship (ECHO PAIN) is an adaptation of the ECHO model where the program goals are to support and improve chronic pain and opioid management in the province of Ontario, Canada.
This study aimed to investigate the perceptions of HCPs participating in ECHO PAIN.
Thirteen HCPs attending ECHO PAIN participated in in-depth semistructured phone interviews. Resulting data were analyzed through a qualitative descriptive lens.
Analysis uncovered four themes: (1) HCPs' motivation for joining ECHO PAIN, (2) interprofessional collaboration through ECHO PAIN, (3) the use of opioids for pain management, and (4) barriers and facilitators to participation and satisfaction in ECHO PAIN. HCPs joined ECHO PAIN because of their struggles managing their complex patients with chronic pain. HCPs also recognized the importance of interprofessional collaboration in pain management and shared examples of integration of different professional approaches in their clinical teams. Opioids for pain management remained a controversial issue, and ECHO served as an opportunity to decrease this knowledge gap. Finally, HCPs described how time constraints, organizational support, and session structure acted as barriers to their participation and satisfaction in the ECHO PAIN program; technology mediated satisfaction.
This study was the first in Canada to explore the motivations of HCPs in attending a chronic pain telementoring program as well as to examine the interprofessional effects of participation. HCPs increased their knowledge about management of chronic pain and increased their interprofessional approach.
慢性疼痛影响着五分之一的加拿大人。一线医疗保健提供者(HCPs)管理着大多数慢性疼痛患者,但接受的相关培训却很少。社区医疗成果扩展(ECHO)模式™是一种针对医疗保健提供者(而非患者)的教育干预措施,旨在为服务不足的社区提供支持并改善医疗服务。安大略省慢性疼痛与阿片类药物管理ECHO(ECHO PAIN)是ECHO模式的一种改编形式,该项目的目标是支持并改善加拿大安大略省的慢性疼痛和阿片类药物管理。
本研究旨在调查参与ECHO PAIN项目的医疗保健提供者的看法。
13名参加ECHO PAIN项目的医疗保健提供者参与了深入的半结构化电话访谈。通过定性描述的视角对所得数据进行分析。
分析发现了四个主题:(1)医疗保健提供者参与ECHO PAIN项目的动机;(2)通过ECHO PAIN项目进行的跨专业协作;(3)使用阿片类药物进行疼痛管理;(4)参与ECHO PAIN项目及满意度的障碍和促进因素。医疗保健提供者参与ECHO PAIN项目是因为他们在管理复杂的慢性疼痛患者时遇到困难。他们也认识到跨专业协作在疼痛管理中的重要性,并分享了临床团队中整合不同专业方法的实例。使用阿片类药物进行疼痛管理仍然是一个有争议的问题,而ECHO项目提供了一个缩小这一知识差距的机会。最后,医疗保健提供者描述了时间限制、组织支持和课程结构如何成为他们参与ECHO PAIN项目及满意度的障碍;技术影响了满意度。
本研究是加拿大首个探索医疗保健提供者参加慢性疼痛远程指导项目的动机以及考察参与项目的跨专业效果的研究。医疗保健提供者增加了他们对慢性疼痛管理的知识,并增强了跨专业方法。