Lessons Learned from the Chronic Pain Clinic: A Qualitative Study of the Perspectives of Healthcare Providers

Abstract

Aim: The chronic pain clinic (CPC) was established to address chronic non-cancer pain and opioid-related harm. Materials & methods: Employing community participatory research design First Nation Metis representatives, clinicians and a researcher collectively agreed to document lessons learned from healthcare providers’ perspective, 1 year post-clinic-implementation. 17 individual interviews were conducted. Results: Thematic analysis revealed that a multidisciplinary team offered client-centered care, education, counseling and multimodal treatment options. Medication reviews and case management ensured patient safety. Communication and education of community providers enhanced pain management capacity ensuring safe opioid prescribing. Evidence-based best practices were implemented through system-level monitoring. Access to Indigenous healing strategies provided culturally responsive spiritual care upon request. Conclusion: The multidisciplinary and multimodal CPC care model effectively manages chronic non-cancer pain.

Tweetable abstract

CPC multidisciplinary team provides comprehensive care including a combination of education, counseling, physical, mind and pharmacological therapies and traditional care to manage chronic pain and opioid use.

Keywords::

• chronic pain
• client-centered care
• multidisciplinary team
• multimodal approach
• safe opioid prescribing

Author contributions

M Pandey: Developed the research design, prepared ethics application, carried out interviews with patients, data collection, analysis, and prepared the first draft of the manuscript R Marwah: Is the clinical lead and the pain specialist and developed the Chronic Pain Clinic program. She identified eligible healthcare providers for interviews. Reviewed and edited data analysis and edited the draft of the manuscript. E Paluck: Reviewed data analysis and the patient chart review and edited the final version of the manuscript. S Maierhoffer, RPN¹: Helped connect with the healthcare providers reviewed and edited final manuscript. D Rude: Reviewed draft provided information about Indigenous protocols, edited the interview questionnaire for the Indigenous staff members and medicine man. Created opportunities for the first and the last author to participate in the traditional ceremonies and arranged a consultation session with the medicine man. Review and edited the manuscript to ensure correct terminology was used when referring to Indigenous people. L Oaks: Ensured that the Indigenous cultural perspectives were reflected accurately in the data analysis and the manuscript.

Acknowledgments

We thank the research participants for sharing their views. We thank Amanda Oliver for, booking appointments and transcribing the interview data. We also thank those who comprise the 9-member ‘Sponsor Committee’ of clinicians and stakeholders for their insights.

Financial & competing interests disclosure

This project received funding $15000 from Saskatchewan Center for Patient-Oriented Research, Saskatchewan, Canada (grant ID 3442) in 2019 to hire a research assistant for data collection for the study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that this study was approved by the Research Ethics Board at Saskatchewan Health Authority, Regina, Saskatchewan, Canada (REB 19-23) or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations.

Additional information

Funding

This project received funding $15000 from Saskatchewan Center for Patient-Oriented Research, Saskatchewan, Canada (grant ID 3442) in 2019 to hire a research assistant for data collection for the study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.