Accessing care in multidisciplinary pain treatment facilities continues to be a challenge in Canada
Accessing care in multidisciplinary pain treatment facilities continues to be a challenge in Canada
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DOI：
10.1136/rapm-2020-101935
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发表时间：
2020-12-01
影响因子：
5.1
通讯作者：
Pereira, John
中科院分区：
文献类型：
--
作者：
Choiniere, Manon;Peng, Philip;Pereira, John
背景多学科疼痛治疗机构（MPTFs）被认为是治疗慢性疼痛（CP）的最佳场所。本研究旨在（1）确定加拿大各地MPTF的分布，（2）记录获得服务的时间和类型，（3）将结果与2005- 2006年的结果进行比较。方法本横断面研究使用与2005-2006年相同的MPTF定义-即，诊所配备至少三个不同学科的专业人员（包括至少一个医学专业），其服务与设施相结合。一个全面的搜索策略被用来确定现有的MPTF在加拿大。行政领导在每个MPTF被邀请完成一份在线问卷调查，就其facility.Results问卷完成了104 MPTF（响应率79.4%）。与12年前相比，加拿大各地的MPTF分布几乎没有变化。大多数（91.3%）集中在大城市。爱德华王子岛和各领土仍然缺乏多信托基金。仅儿科MPTF的数量几乎翻了一番，但仍然很小（n=9）。公共资助的MPTF首次任命的平均等待时间与12年前大致相同（5.5 vs 6个月）。结论在加拿大，获得公共MPTF的机会仍然有限，导致首次预约的等待时间过长。需要以社区为基础的MPTF和虚拟护理计划，将疼痛服务分发到区域和偏远社区，为CP患者提供最佳护理。
Background Multidisciplinary pain treatment facilities (MPTFs) are considered the optimal settings for the management of chronic pain (CP). This study aimed (1) to determine the distribution of MPTFs across Canada, (2) to document time to access and types of services, and (3) to compare the results to those obtained in 2005-2006.Methods This cross-sectional study used the same MPTF definition as in 2005-2006-that is, a clinic staffed with professionals from a minimum of three different disciplines (including at least one medical specialty) and whose services were integrated within the facility. A comprehensive search strategy was used to identify existing MPTFs across Canada. Administrative leads at each MPTF were invited to complete an online questionnaire regarding their facilities.Results Questionnaires were completed by 104 MPTFs (response rate 79.4%). Few changes were observed in the distribution of MPTFs across Canada compared with 12 years ago. Most (91.3%) are concentrated in large urban cities. Prince Edward Island and the Territories still lack MPTFs. The number of pediatric-only MPTFs has nearly doubled but remains small (n=9). The median wait time for a first appointment in publicly funded MPTFs is about the same as 12 years ago (5.5 vs 6 months). Small but positive changes were also observed.Conclusion Accessibility to public MPTFs continues to be limited in Canada, resulting in lengthy wait times for a first appointment. Community-based MPTFs and virtual care initiatives to distribute pain services into regional and remote communities are needed to provide patients with CP with optimal care.