未经评估:阿肯色州缺乏获得高质量疼痛护理的机会,作为证据,在某种程度上,它拥有美国第二高的阿片类药物处方率。为了改善慢性疼痛的高质量治疗,我们开发了阿肯色州改善多学科疼痛护理和治疗(AR-IMPACT)远程医疗诊所,一个多学科和跨专业的专家团队,为慢性疼痛患者提供循证疼痛管理。
UNASSIGNED:我们在农村进行了AR-IMPACT远程医疗诊所的单臂试点试验,大学附属初级保健诊所。我们使用实施框架和初步有效性措施评估了AR-IMPACT远程医疗诊所。具体来说,我们评估了该框架8项实施成果中的5项(即,穿透力,收养,可接受性,适当性,和可行性)使用混合方法方法。为了评估实施结果,我们用调查,采访,和行政数据。我们使用电子健康记录数据来衡量初步有效性(即,每天平均吗啡毫克当量和疼痛和抑郁评分的变化)。
未经评估:AR-IMPACT团队观察了23名患者,这些患者由来自三个农村的13名初级保健医生转诊,大学附属初级保健诊所一年以上。在愿意参与试点研究的19名患者中,12人被认定为女性,31.6%被确定为黑色,超过50%的人接受的教育程度低于学士学位。患者对诊所的总体满意度很高。转诊的医生表示高度适当,可接受性,方案的可行性。AR-IMPACT团队成员确定了实施该计划的可行性的几个障碍和促进者。初步有效性指标无统计学变化。
未经评估:总的来说,AR-IMPACT远程医疗诊所获得了适度的渗透和采用,患者高度接受,对提供者来说是高度可接受和适当的,对提供者和AR-IMPACT团队成员来说是适度可行的。
UNASSIGNED: Arkansas lacks adequate access to high-quality pain care, as evidenced, in part, by it having the second highest opioid prescribing rate in the United States. To improve access to high-quality treatment of chronic pain, we developed the Arkansas Improving Multidisciplinary Pain Care and Treatment (AR-IMPACT) Telemedicine Clinic, a multidisciplinary and interprofessional team of specialists who provide evidence-based pain management for patients with chronic pain.
UNASSIGNED: We conducted a single-arm pilot trial of the AR-IMPACT Telemedicine Clinic with rural, university-affiliated primary care clinics. We assessed the AR-IMPACT Telemedicine Clinic using an implementation framework and preliminary effectiveness measures. Specifically, we assessed 5 of the 8 implementation outcomes of the framework (ie, penetration, adoption, acceptability, appropriateness, and feasibility) using a mixed methods approach. To evaluate implementation outcomes, we used surveys, interviews, and administrative data. We used electronic health record data to measure preliminary effectiveness (ie, changes in average morphine milligram equivalents per day and pain and depression scores).
UNASSIGNED: The AR-IMPACT team saw 23 patients that were referred by 13 primary care physicians from three rural, university-affiliated primary care clinics over one year. Of the 19 patients willing to participate in the pilot study, 12 identified as women, 31.6% identified as Black, and over 50% had less than a bachelor\'s level education. Patients rated the clinic positively with high overall satisfaction. Referring physicians indicated high levels of appropriateness, acceptability, and feasibility of the program. AR-IMPACT team members identified several barriers and facilitators to the feasibility of implementing the program. No changes in preliminary effectiveness measures were statistically significant.
UNASSIGNED: Overall, the AR-IMPACT Telemedicine Clinic obtained moderate penetration and adoption, was highly acceptable to patients, was highly acceptable and appropriate to providers, and was moderately feasible to providers and AR-IMPACT team members.