Creation of a Multispecialty Clinic for Patients with Central Sensitization–Based Chronic Pain Conditions, 2021, Loftus et al

Abstract

Objective
To design and evaluate, through a human-centered design approach, a multispeciality clinic for patients with central sensitization syndromes that combined virtual previsit consultations, traditional face-to-face appointments, and technology-enabled educational programming.

Patients and Methods
Patients with suspected fibromyalgia and chronic abdominal pain were seen in a multispecialty practice, and the performance of the clinic was evaluated against a contemporary cohort. Quantitative and qualitative evaluation measures included team estimates of time spent on care-related tasks, physician rank of alignment of patient need with clinic design, major appointment changes, and nonvisit care tasks. Members of the care team also evaluated strengths, weaknesses, opportunities, and threats to the success of the clinic.

Results
The pilot clinic was operated from April 1, 2020, to April 30, 2021, and included 34 patients with suspected fibromyalgia/chronic abdominal pain. During the pilot period, physicians ranked the value of the virtual previsit consultations in providing care as 7.5 on a scale of 0 to 10 and reported an average of 50 minutes in preparation for the appointment, execution of the appointment, and postvisit documentation. We did not observe substantial differences in the number of added appointments or messages received within the patient portal when compared with a comparison cohort. Patients who participated in the combination nurse educator–led and digital education program provided positive feedback about their experience.

Conclusion
Our clinic model provides a framework for the treatment of patients with debilitating centrally sensitized conditions and future expansion of virtual care delivery models to better meet patient care and educational needs.

Open access, https://www.mcpiqojournal.org/article/S2542-4548(21)00160-0/fulltext

 

"Beyond FM, there are many other conditions that are pathophysiologically based in CS. These conditions include, but are not limited to, irritable bowel syndrome (IBS)/chronic abdominal pain (the global prevalence of IBS is estimated to be 11%, with health care costs in excess of $20 billion annually), 10 chronic fatigue syndrome/myalgic encephalomyelitis (affecting up to 2.5 million Americans, with an associated economic cost of between $17 billion and $24 billion annually), 11 temporomandibular joint disorder (affecting approximately 5% to 12% of the US population, with medical costs exceeding $4 billion annually), 12 postural tachycardia syndrome (estimated prevalence of 0.2%), 13 and cough hypersensitivity syndrome (affecting up to 10% of all individuals with chronic cough). 14, 15 As a result, the Centers for Disease Control and Prevention, the Institute of Medicine, and the Chronic Pain Research Alliance recently put forth the term chronic overlapping pain conditions to demonstrate the interrelatedness and shared pathophysiology (CS) of these and many other conditions."

"There are 17 distinct sections included within the online education programming, including a review of the biology of CS, an overview of how self-management can aid in symptom management, and a range of self-directed symptom management approaches that patients can engage in. Examples of described self-directed symptom management approaches included management of emotions and behaviors, sleep hygiene, the role of exercise and graded movement, and nutrition."

 

There are more marketing buzzwords in the abstract than in most MBA classes.

I don't see how that conclusion relates to anything. They don't show evidence of any benefits whatsoever. They did a thing, and reported that they did a thing. And in EBM, this is evidence. Mercy.

 

Mayo Clinic...who else would simpleton this.

What on earth could a patient with FM learn from an approach that isn't specific to FM (though many FMers do have IBS).

I am for specialized clinics with intelligent, compassionate, and dedication MDs and staff. Talented human beings to relieve suffering, offer understanding and encourage people to find others with the same condition. Point final.

 

job creation for the sake of creating more employment for the clueless medical professionals. certainly it is not for the benefit of patients with conditions that require real research .

 

So, uh, how did the patients rank it?