Provision of Recommended Chronic Pain Assessment and Management in Primary Care: Does Patient-Centered Medical Home (PCMH) Recognition Make a Difference?
| Autor: | Michelle Penm, Ryan Joseph Imhoff, Nancy C. Elder, Mary Beth Vonder Meulen, Amy D. Short, Brendan Wilson, Jill Boone, Harini Pallerla, Tiffiny Diers |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Medical home medicine.medical_specialty Primary care 03 medical and health sciences 0302 clinical medicine Documentation Nursing Patient-Centered Care Humans Pain Management Medicine 030212 general & internal medicine Prescription Drug Misuse Ohio Pain Measurement Primary Health Care business.industry Public Health Environmental and Occupational Health Chronic pain Middle Aged medicine.disease Analgesics Opioid Substance abuse Distress Family medicine Practice Guidelines as Topic Cohort Female Chronic Pain Family Practice business Psychosocial 030217 neurology & neurosurgery |
| Zdroj: | The Journal of the American Board of Family Medicine. 29:474-481 |
| ISSN: | 1558-7118 1557-2625 |
| DOI: | 10.3122/jabfm.2016.04.160037 |
| Popis: | Background: Chronic pain (CP) care in the patient-centered medical home (PCMH) model has not been well studied. We assessed whether PCMH recognition is associated with increased provision of key practice recommendations for CP assessment and management. Methods: Chart reviews were completed for 12 primary care practices affiliated with one health system in the Cincinnati Area Research and Improvement Group (CARInG). Recommendations were abstracted and compared based on PCMH status: 3 practices had received prior PCMH level 3 recognition, 5 were in an ongoing process of applying, and 4 had no recognition and were not applying. Results: A total of 485 charts were reviewed from 65 PCPs. Eight of 10 key recommendations were documented more often in the prior and ongoing PCMH cohorts, including assessing pain severity, function, psychosocial distress, and substance abuse, and using structured instruments for these assessments. There were fewer differences between the cohorts in the management of chronic opioids, with only the ongoing PCMH cohort having higher documentation for 5 of the 7 recommendations, including performing urine drug screens and using a structured instrument to assess for misuse. Conclusions: These findings support the usefulness of the PCMH model in managing patients with CP, but patient outcomes need to be addressed in future studies. |
| Databáze: | OpenAIRE |
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