Reducing Opioid Reliance in Veterans Using a Whole Health Education and Shared Medical Appointment Care Model

ABSTRACT

Background

Reducing opioid reliance in chronic pain treatment may best be accomplished with interdisciplinary teams. Shared Medical Appointments (SMAs) are one format whereby an interdisciplinary team partners with groups of patients to provide health education and clinical care. The Whole Health (WH) model is an emerging framework whereby the care team partners with the patient to reach shared goals with emphasis on self-care and healing modalities.

Purpose

Assess the impact of a WH Education intervention in patients with chronic pain and long-term opioid use within the framework of Shared Medical Appointment (SMA).

Results

Retrospective chart review of 86 participants indicated significant opioid reduction at 12 and 24 months. The rate of opioid reduction in the SMA group surpassed the rate of decline of the host or national VA cohorts. Overall pain perception did not increase while patient satisfaction and safety indices improved.

Discussion

Results of the intervention suggest that a WH education model in a SMA is one approach to help patients reduce long-term opioid reliance.

Translation to Health Education Practice: Trained Whole Health Coaches/Education Specialists are key personnel in the implementation of the WHSMA model of care and facilitators of behavioral change that results in improved wellness outcomes.

A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

Acknowledgments

The following individuals made significant contributions to the success of the WH-SMA: Health Coaches/Health Educators/HES Traci Carlisle, LPN, Latonya Johnson, LPN, Victoria Moore, RN, Princess Pippen, RN; Ms. Gail Carter; Kim Chism, RD; Dr. Durinda Warren; Pharmacy-led education (Liz-Marie Avilez-Gonzales, PharmD, Lisa Ambrose, PharmD, Meredith Thompson, PharmD); Mental Health Psychologist, Craig Alexander, Ph.D.; Other SMEs from our VA. A special thanks to WH Peer Support, Veteran Mr. Jerry McClain and Volunteer Movement/Yoga Specialist, Veteran Ms. Deborah Parker who led multiple sessions with mindfulness and chair yoga. The Office of Patient Centered Care & Cultural Transformation’s comprehensive Web site with educational and training materials made this project feasible in primary care.

Disclosure statement

The authors report there are no competing interests to declare. This work was reviewed by the Birmingham VA IRB as non-Research or Quality Improvement.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.