Abstract
ABSTRACT Background Chronic pain is one of the most widely recognized, disabling, and expensive health problems in Canada. Interdisciplinary multimodal pain management is effective in helping chronic pain patients lessen symptoms and reclaim functionality, but most patients lack access to such treatments. Aim The aim of this study was to describe the development and implementation of a publicly funded and patient-centered model of care in the community. Methods The study was set in the Pain & Wellness Centre (PWC) in Vaughan, the only community-based chronic pain clinic in Ontario funded by the Ontario Ministry of Health and Long-Term Care (MOHLTC) as a demonstration project of a template for similar future community clinics. The study is descriptive, including a brief review of the Ontario comprehensive pain strategy framework and an overview of the PWC and the process involved in the development of an interdisciplinary pain program (IDP), based on the biopsychosocial model of chronic pain management. Results During a 2.5-year period, the PWC has offered 1055 new patient medical consultations and 1921 follow-up visits and admitted 242 patients in the IDP program (demonstrating significant success in patient outcomes at the 3-month exit from the program). It established robust outcomes research, organized educational programs for pain trainees, and cultivated a collaborative relationship with the Toronto Academic Pain Medicine (TAPMI) network and the community at large. Conclusions This demonstration program has shown the feasibility and applicability of the principles of the MOHLTC comprehensive pain strategy, providing an effective, evidence-based, and accountable approach to chronic pain diagnosis and management in the community.
Highlights
Chronic pain is one of the most widely recognized, disabling, and expensive health problems in Canada
The Pain & Wellness Centre (PWC) offers medical consultations and management, is accessible to community referrals for treatment of patients funded by third parties, and reports directly to Ministry of Health and Long-Term Care (MOHLTC), which funds interdisciplinary pain services and support staff
We further provide continuous health education sessions for the local physicians and occasional lectures to the public
Summary
Chronic pain is defined as (1) pain lasting >3 to 6 months or (2) beyond the expected healing time typical of a disease or injury. The funding exclusively supported teams of allied health professionals and administrative support staff to allow more patients to access the biopsychosocial model of care This funding is coupled with other key initiatives supporting chronic pain care across the lines of the Ontario comprehensive chronic pain strategy framework, such as the creation of pediatric and adult advisory boards to develop a networked system with a common information registry and standard models of care; Project ECHO (Extension for Community Healthcare Outcomes, which started in 2014), which connects primary care providers from across Ontario with each other and with interdisciplinary pain specialist teams via weekly videoconferencing sessions; integrating patients from the provincial committee level to each individual chronic pain clinic; creating new quality standards by Health Quality Ontario; developing Inter-professional Spine Assessment and Education Clinics (low back pain centers), which started in 2013 and expanded by 2017; continuing with a Narcotics Monitoring System; publicly funding shingles vaccines for people between 65 and 70 years of age (announced in 2016); and promoting an opioid strategy (announced in 2016) that includes chronic pain management as a key component of the strategy (MOHLTC Ontario Chronic Pain Advisory Network Briefing Document [Pediatric and Adult], excerpts from email, February 1, 2018). ● Body responsible for providing supervision, policy development, governance structure, monitoring, and reporting
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
