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车轮上的治愈:为慢性疼痛患者开展社区外展和团体医疗服务的开发与实施

Heals on Wheels: Development and Implementation of Community Outreach and Group Medical Visits for People Experiencing Chronic Pain.

作者信息

Justice Catherine, Haddow Susan, Shafto Katherine, Reeves Tegan, Knox Jadyn E, Prasad Arti

机构信息

Hennepin Healthcare Systems, Integrative Health - Department of Medicine, Minneapolis, MN, USA.

Hennepin Healthcare Systems, Department of Family Medicine, Minneapolis, MN, USA.

出版信息

Glob Adv Integr Med Health. 2025 Feb 24;14:27536130251322501. doi: 10.1177/27536130251322501. eCollection 2025 Jan-Dec.

Abstract

BACKGROUND

Chronic pain is a global problem affecting approximately 20% of adults. The prevalence of opioid use for chronic pain has contributed to a widespread crisis of addiction and inadequately managed pain. Though national and international guidelines recommend nonpharmacological, integrative, multi-modal therapies for chronic pain, numerous systemic barriers limit access to these services for those with the highest need and fewest resources.

OBJECTIVE

This paper describes the development and testing of an innovative "Heals on Wheels" (HoW) community engagement and Group Medical Visit (GMV) program for underserved communities experiencing chronic pain in Hennepin County, Minnesota.

METHODS

The HoW program's curriculum was collaboratively adapted from pre-existing Hennepin Health care GMV programs for chronic pain. Free community-based "Appetizer" workshops were developed alongside an 8-week "Full Meal" GMV program titled (EPH). Three pain-affinity variations of EPH were created (the "Body", "Head", and "Heart") and delivered to 6 cohorts (2 cohorts of each variation). Feasibility was measured by attendance, demographics, and insurance provider information. To evaluate program acceptability, thematic analysis of patients post-GMV weekly progress sheets was performed.

RESULTS

The curriculum for the HoW program included experiential training and education in evidence-based integrative pain management strategies. Fourteen community appetizer workshops (n = 142) were offered in partnership with organizations representing underserved populations. Fifty-five patients completed EPH from 2022 to 2024 with the greatest number of patients in the Heart (n = 23), followed by the Body (n = 19), and the Head (n = 13). Feasibility for the GMV program was demonstrated with average attendance across 6 cohorts at 75.1%. Thematic analysis of qualitative data revealed themes highlighting appreciation for group connection ("sharing") and the EPH program content.

CONCLUSION

The HoW program shows promise as a feasible and acceptable model of community outreach and engagement to improve access to evidence-based integrative pain care.

摘要

背景

慢性疼痛是一个全球性问题,影响着约20%的成年人。用于慢性疼痛的阿片类药物的广泛使用导致了成瘾和疼痛管理不善的普遍危机。尽管国家和国际指南推荐采用非药物、综合、多模式疗法来治疗慢性疼痛,但众多系统性障碍限制了最需要且资源最少的人群获得这些服务。

目的

本文描述了一项创新的“车轮上的康复”(HoW)社区参与和团体医疗就诊(GMV)项目的开发与测试,该项目针对明尼苏达州亨内平县患有慢性疼痛的服务不足社区。

方法

HoW项目的课程是在亨内平县医疗保健中心现有的慢性疼痛GMV项目基础上合作改编而成。免费的社区“开胃菜”工作坊与一个为期8周的名为(EPH)的“正餐”GMV项目一同开发。创建了EPH的三种疼痛亲和变体(“身体”“头部”和“心脏”),并分发给6个队列(每个变体2个队列)。通过出勤率、人口统计学和保险提供商信息来衡量可行性。为了评估项目的可接受性,对GMV后患者的每周进度表进行了主题分析。

结果

HoW项目的课程包括基于证据的综合疼痛管理策略的体验式培训和教育。与代表服务不足人群的组织合作举办了14次社区开胃菜工作坊(n = 142)。2022年至2024年期间,55名患者完成了EPH,其中“心脏”组患者最多(n = 23),其次是“身体”组(n = 19)和“头部”组(n = 13)。GMV项目的可行性通过6个队列的平均出勤率75.1%得到证明。定性数据的主题分析揭示了一些主题,突出了对团体联系(“分享”)和EPH项目内容的赞赏。

结论

HoW项目有望成为一种可行且可接受的社区外展和参与模式,以改善基于证据的综合疼痛护理的可及性。

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