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多学科慢性疼痛诊所的分诊流程:当前程序的国际综述

Triage processes at multidisciplinary chronic pain clinics: An international review of current procedures.

作者信息

Pagé M Gabrielle, Ziemianski Daniel, Shir Yoram

机构信息

Alan Edwards Pain Management Unit, Montreal General Hospital, Montreal, Quebec, Canada.

School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.

出版信息

Can J Pain. 2017 Oct 23;1(1):94-105. doi: 10.1080/24740527.2017.1331115. eCollection 2017.

Abstract

: Multidisciplinary pain clinics are considered the gold standard for the treatment of chronic pain, yet access to such clinics is difficult and patients' conditions deteriorate while waiting. Instituting a triage process is one way of reducing wait time for some patients and ensuring optimal access given the limited resources available. Surprisingly, there are no established guidelines on how to optimally triage chronic pain patients at tertiary multidisciplinary pain clinics. : The goal of this study was to gather information regarding existing triage systems in multidisciplinary chronic pain clinics worldwide as an initial step toward establishing a definitive evidence-based set of triage guidelines. : A total of 66 multidisciplinary pain clinics worldwide completed an online survey detailing current triage practices at their clinic. The survey was distributed via international and national pain associations. : Results showed that the vast majority of multidisciplinary pain clinics (94%) use a triage system, yet many difficulties with these systems have been identified (time requirement, administrative burden, lack of control over scheduling, missing high-priority patients, and prioritizing low-priority patients). The level of satisfaction was noted to be higher in those clinics using a structured triage template. : This study identified a need for the elaboration of best practice clinical guidelines for triage processes at tertiary pain clinics. The use of a structured referral template could become a central element to such guidelines.

摘要

多学科疼痛诊所被认为是治疗慢性疼痛的金标准,但患者很难进入这类诊所,且在等待过程中病情会恶化。设立分诊流程是减少部分患者等待时间并在资源有限的情况下确保最佳就诊机会的一种方式。令人惊讶的是,目前尚无关于如何在三级多学科疼痛诊所对慢性疼痛患者进行最佳分诊的既定指南。

本研究的目的是收集有关全球多学科慢性疼痛诊所现有分诊系统的信息,作为建立一套明确的循证分诊指南的第一步。

全球共有66家多学科疼痛诊所完成了一项在线调查,该调查详细说明了其诊所当前的分诊做法。该调查通过国际和国家疼痛协会进行分发。

结果显示,绝大多数多学科疼痛诊所(94%)使用了分诊系统,但也发现了这些系统存在的许多问题(时间要求、行政负担、对排班缺乏控制、遗漏高优先级患者以及将低优先级患者列为优先)。使用结构化分诊模板的诊所满意度更高。

本研究确定需要为三级疼痛诊所的分诊流程制定最佳实践临床指南。使用结构化转诊模板可能会成为此类指南的核心要素。

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