Background: Mounting concern about the risks and limited effectiveness of opioid therapy for chronic pain has spurred the implementation of novel integrated biopsychosocial pain care models in health-care systems like the Department of Veterans Affairs (VA). However, little is known about patient experiences with these new care models.
Objective: We conducted a qualitative study to examine patient experiences with a pain care model currently being disseminated at the VA: interdisciplinary, integrated pain teams (IPTs) embedded in primary care.
Method: We interviewed 41 veterans who received care from VA's first IPT to learn how working with the team impacted their pain care and quality of life. We asked about their overall experience with IPT, what worked and did not work for them, and what changes they would recommend to improve IPT care.
Results: The interviews revealed a wide spectrum of patient experiences and varying perspectives on the extent to which the new model improved their pain and quality of life. Thematic analysis shed light on factors impacting patients' experiences, including pretreatment goals and expectations as well as attitudes toward opioids and nonpharmacological treatments.
Conclusion: We discuss the implications of our findings for national efforts to implement biopsychosocial pain care, and we offer recommendations to promote patient-centered implementation.
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http://dx.doi.org/10.1177/2164956119838845 | DOI Listing |
Cranioplasty is an operation that aims to repair a defect in the skull. Indications commonly include Traumatic Brain Injury (TBI), tumours, and infections. It carries a high rate of postoperative morbidity.
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January 2025
The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
The C3PO collaborative, with a history of successful quality improvement (QI) initiatives, leveraged registry participants to develop a multi-center QI initiative to reduce adverse events (AEs) in congenital cardiac catheterization. A 32-person, interdisciplinary working group analyzed audited data for all congenital cardiac catheterization cases from 2014-2017. The primary outcome was the occurrence of any high-severity (level 3/4/5) AE.
View Article and Find Full Text PDFAnesthesiology
February 2025
Division of Obstetric Anesthesiology, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Preeclampsia is a common condition of pregnancy characterized by hypertension complicated by cerebral, cardiac, hepatic, renal, hematologic, and placental dysfunction. Patients with preeclampsia frequently undergo cesarean delivery, the most common major surgical procedure in the world. They represent a high-risk perioperative cohort suffering significant preventable morbidity and mortality.
View Article and Find Full Text PDFAnesthesiology
February 2025
Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, and the Department of Anesthesia, Harvard Medical School, Boston, Massachusetts.
J Am Coll Surg
January 2025
Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.
Introduction: Pathway-driven, post-pancreatectomy opioid reduction interventions have proven effective and sustainable and may have a "halo effect" on other major abdominal cancer operations. This study's aim was to analyze the sequential effects of expanding opioid reduction efforts from pancreatectomy on opioids prescribed after hepatectomy.
Methods: This is a retrospective cohort study utilizing data from the electronic health record and a prospective quality improvement database for consecutive hepatectomy patients (09/2016-02/2024).
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