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Year:: 2019
Contributor:: Crandall, Christina K. (Creator); Cohen, Lauren E. (Advisor); Blackwood, Reina (Advisor); Anandarajah, Gowri (Advisor); Tobin-Tyler, Elizabeth (Advisor); Brown University. The Warren Alpert Medical School. Brown Gateways to Medicine, Health Care, and Research (Sponsor)
Subject:: Medicine; Opioids; Pain management; chronic pain; pain medications; alternative treatments; group therapy; meditation; acupuncture; yoga; pain scales; doctor patient communication; social support networks
DOI: https://doi.org/10.26300/ngb1-vd65

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Abstract:: Background: Thirty years ago, concerned about patients’ untreated pain, doctors began treating pain aggressively and prescribing opioids liberally. Fifty million U.S. adults (20.4%) live with chronic pain. Rhode Island had over double the rate of opioid-related overdose deaths in 2016, ranking in the top ten states. This quality improvement (QI) project assisted PCHC in improving chronic pain healthcare, and assessed the efficacy of prior group therapy sessions, which incorporated information, meditation, acupuncture, and yoga. Methods: A quantitative and qualitative survey was created for PCHC with 45 data points (e.g., demographics; medications; pain characteristics; attendances; communications). Data analysis focused on patients’ chronic pain/medications, and interactions between data points. Literature review included pain scales and alternative therapies. Results: QI results revealed 32 Registered Patients (17 No Shows; 15 Participants; 11 Respondents) of which 31 were prescribed multiple pain medications. Of patients prescribed opioids, 75% were No Shows. When asked if others understand/acknowledge their pain, 80% of “yes’s” were married versus 75% of “no’s” were single. Only three Respondents felt they can communicate their pain to doctors. Literature results identified 45+ pain scales, and 23+ non-medicated/non-opioid alternative therapies. Conclusions: PCHC’s prior sessions were well-received and illuminated areas for improvement. However, efficacy on reducing patients’ chronic pain and medication usage could not be validated. Doctor/patient communication results support utilization of pain scales; and relationship results are consistent with pain studies showing the importance of social supports. One hypothesis for the variance between participation rates of patients on opioids versus non-opioids could be that patients on opioids are not as motivated to seek alternative treatments; whereas Participants sought alternative treatments, because their pain persisted even with non-opioid pain medications. This QI project highlights the difficulties in motivating patients to utilize alternative non-medication/non-opioid treatments. Additional research is needed, including ways to incentivize patients.
Notes:: Capstone (Sc.M. in Medical Sciences)--Brown University, 2019

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Use and Reproduction: This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license

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Crandall, Christina K., "Abstract for 'Efficacy of Non-medicated/Non-opioid Treatments for Chronic Pain in Providence Community Health Center (PCHC) Patients'" (2019). Gateways to Medicine, Health Care, and Research. Brown Digital Repository. Brown University Library. https://doi.org/10.26300/ngb1-vd65

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Efficacy of Non-medicated/Non-opioid Treatments for Chronic Pain in Providence Community Health Center (PCHC) Patients

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Gateways to Medicine, Health Care, and Research

The Gateways Program at the Warren Alpert Medical School of Brown University provides academically promising, motivated students new pathways to careers in the health sciences. This collection houses scholarly works produced by Master of Science in Medical Sciences (ScM) students …
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Abstract for "Efficacy of Non-medicated/Non-opioid Treatments for Chronic Pain in Providence Community Health Center (PCHC) Patients"