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安大略省西北部社区医疗保健成果扩展项目(ECHO)慢性疼痛与阿片类药物管理:患者病例的主题分析

Extension for Community Healthcare Outcomes (ECHO) Chronic Pain & Opioid Stewardship in Northwestern Ontario: A Thematic Analysis of Patient Cases.

作者信息

Poulin Patricia A, Shergill Yaadwinder, Grebowicz Adrian, Almeida Inês, Cantave Rosemee, MacLeod Bryan, Larocque Tim, Garstin Donna, Fitzgerald Sarah F, Rash Joshua A

机构信息

St Joseph's Care Group, Project ECHO Chronic Pain & Opioid Stewardship, Thunder Bay, ON, Canada.

Department of Psychology, Ottawa Hospital, Ottawa, ON, Canada.

出版信息

Can J Pain. 2022 Nov 28;6(1):211-224. doi: 10.1080/24740527.2022.2126754. eCollection 2022.

Abstract

BACKGROUND

Chronic pain (CP) is a debilitating disease that reduces quality of life, decreases productivity, and has become a primary cause of health care resource consumption. Despite this, many Canadian family physicians have received little formal education in managing CP, making it one of the most challenging areas of practice in primary care. Project Extension for Community Healthcare Outcomes Chronic Pain & Opioid Stewardship St. Joseph's Care Group (Project ECHO-SJCG) is an evidence-based educational program connecting community-based health care providers (HCPs) with an interprofessional team by videoconference to learn about management of CP in rural, remote, and underserved areas.

AIMS

To explore key learning points from cases presented at Project ECHO-SJCG, identify and analyze themes and improve future sessions of continuing professional development for HCPs.

METHODS

We completed a thematic analysis of forty cases and key learning points using the constant comparison method. We also summarized descriptive statistics for patient and provider characteristics.

RESULTS

Forty cases were presented by 31 HCPs, who received suggestions focused on assessment and diagnosis, pharmacological and non-pharmacological pain symptom management, interventional management, attention to biopsychosocial factors, and appropriate referral to other HCPs.

CONCLUSION

Project ECHO-SJCG cases allow HCPs to gain a broad knowledge base to evaluate and manage CP in their practice. Identified themes highlight common gaps in HCPs' knowledge and will guide future sessions.

摘要

背景

慢性疼痛(CP)是一种使人衰弱的疾病,会降低生活质量、降低生产力,并已成为医疗保健资源消耗的主要原因。尽管如此,许多加拿大家庭医生在慢性疼痛管理方面接受的正规教育很少,这使其成为初级保健中最具挑战性的实践领域之一。社区医疗成果慢性疼痛与阿片类药物管理项目圣约瑟夫护理集团(ECHO-SJCG项目)是一个基于证据的教育项目,通过视频会议将社区医疗服务提供者(HCP)与跨专业团队联系起来,以了解农村、偏远和服务不足地区的慢性疼痛管理。

目的

探索ECHO-SJCG项目中呈现案例的关键学习要点,识别和分析主题,并改进未来为HCP开展的继续职业发展课程。

方法

我们使用持续比较法对40个案例和关键学习要点进行了主题分析。我们还总结了患者和提供者特征的描述性统计数据。

结果

31名HCP展示了40个案例,他们收到了关于评估与诊断、疼痛症状的药物和非药物管理方法、介入管理、对生物心理社会因素的关注以及向其他HCP进行适当转诊的建议。

结论

ECHO-SJCG项目的案例使HCP能够获得广泛的知识基础,以便在实践中评估和管理慢性疼痛。确定的主题突出了HCP知识方面的常见差距,并将指导未来的课程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac5d/9707544/61f4d0c052f6/UCJP_A_2126754_F0001_OC.jpg

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