Interventional Pain Outcome Study

Transcription

1 ssmhealth.com/pain White Paper Interventional Pain Outcome Study

2 Introduction Pain commonly presents as a complex process and is equally as difficult to manage and treat. Acute or chronic, pain differs among patients, gender and age. While science has produced dramatic improvements in diagnosis and treatment, studies to further advance this area of medicine hold great promise. To evaluate patient outcomes in pain reduction following treatment, SSM Health Pain Care partnered with The Center for the Application of Behavioral Science (CABS) at Saint Louis University. CABS provided consultation on survey design, assessment of pain evaluation data, statistical data analysis and prepared a report of the findings. To make the best use of available data and provide a comprehensive view, a system-level analysis was used that combined data from multiple treatment sites. SSM Health will continue to sponsor this pain study and share findings with the physician community. Key : Following a study of 6 patients, large, clinically significant reductions in patient-reported pain intensity were found following the course of treatment. Further, moderate, clinically significant reductions in sensory pain quality and combined sensory and affective pain quality rating were observed. Methodology: Data was collected between November and April using a -question pain evaluation, which included items from the McGill Pain Questionnaire and the Patient- Reported Outcomes Measurement System. Patients were asked to self-report before and after treatment regarding: Pain location Physical health Pain intensity Pain quality Mental health Demographic characteristics Previous Study: An initial pain study was conducted between August and April with 8 participants. Large, clinically significant reductions in patientreported pain intensity were found following the course of treatment.

3 Patient Demographics The average age of study participants was 6 years (range: years to 9 years); percent were female and percent were male. Age of Respondents 8-9 Age of Groupings Number of Respondents Gender Female % Male %

4 Number of Days between Treatments Age Groupings Number of Respondents Pain Location Patients were classified as having an Upper Body pain location if they reported pain in the neck, shoulders, or a combination of these two areas. Respondents were classified as having a Lower Body pain location if they reported pain in the lower back, hips, legs foot, or any combination of these four areas. Participants were classified as having an Upper and Lower Body pain location if they reported pain in both upper and lower body regions. Pre-Treatment Post-Treatment Upper And Lower Body % Upper Body % Upper And Lower Body 6 % Upper Body 7 % Lower Body 66 % Lower Body 67 %

5 Pain Intensity In all areas, pain intensity was significantly less after treatment. Question: How would you rate your pain today? Outcome: Pain after treatment was significantly less. Worst Pain Imaginable Moderate Pain Question: How would you rate your worst pain in the past hours? Outcome: Pain after treatment was significantly less. Worst Pain Imaginable Moderate Pain

6 Question: In the past seven days, how would you rate your pain on average? Outcome: Pain after treatment was significantly less. Worst Pain Imaginable Moderate Pain Question: Descriptor that best describes your pain. Outcome: Pain intensity after treatment was significantly less. Excruciating Horrible Distressing.6.9 Discomforting 6

7 Pain Duration Patients were asked to report on pain before and during treatment and describe pain as: Brief Intermittent Continuous Pain Duration Pre-Treatment Brief % Continuous 7 % Intermittent % Pain Duration Post-Treatment Continuous % Brief % Intermittent 8 % Sensory and Affective Dimensions of Pain The McGill Pain Questionnaire (short form) was used to collect information on pain descriptors. Sensory pain experience after treatment was significantly less, which included ratings for pain descriptors: Throbbing Severe Pain Shooting Stabbing Sharp Cramping Moderate Pain Gnawing Hot-burning Aching Mild Pain.9. Heavy Tender Splitting No Pain 7

8 Affective pain experience after treatment was significantly less, which included ratings for four pain descriptors: Tiring-exhausting Sickening Fearful Punishing-cruel Physical Health Question: In general, how would you rate your physical health? Outcome: Physical health following treatment showed improvement. Severe Pain Moderate Pain Mild Pain..88 No Pain 8

9 Question: To what extent are you able to carry out your everyday physical activities? Outcome: Ability to carry out every day physical activities after treatment showed improvement. Completely Mostly.9. Moderately Question: In the past seven days, how would you rate your fatigue on average? Outcome: Fatigue after treatment was significantly reduced. Excellent Very Good.6. Good 9

10 SSM Health Pain Care Physician Staff Specialty Board Certifications Medical School Residency Fellowship Locations Hugh G. Tad Berry, MD Pain Management Pain Management and Anesthesia University of Missouri Barnes Hospital SSM Health St. Mary s Hospital Michael Boedefeld, MD Therapeutic and Interventional Pain Management Pain Medicine and Anesthesia Creighton University University of Wisconsin Washington University SSM Health St. Clare Hospital and SSM Health St. Joseph Hospital - Wentzville Christopher B. Patton, MD Interventional Pain Management and Pain Medicine Pain Medicine and Anesthesia University of Texas Medical School University of Pennsylvania Mount Sinai Medical Center SSM Health Outpatient Center Chad Shelton, MD Therapeutic and Interventional Pain Management Pain Medicine and Anesthesia University of Missouri Wake Forest University Wake Forest University SSM Health St. Clare Hospital and SSM Health St. Joseph Hospital Wentzville Stephen Smith, MD Pain Medicine and Interventional Pain Management Pain Medicine, Pain Management and Anesthesia University of Alabama at Birmingham School of Medicine Anesthesiology Saint Louis University Health Sciences Center General Surgery Charity Hospital of New Orleans SSM Health DePaul Hospital

11 SSM Health Pain Care Physician Staff Sean P. Stoneking, MD Pain Medicine and Interventional Pain Management Pain Medicine and Anesthesia Saint Louis University Saint Louis University Hospital Cedars-Sinai Medical Center SSM Health St. Joseph Hospital Lake St. Louis Ellis Taylor, MD Pain Medicine Anesthesia and Credentials in Pain Management Washington University Barnes Hospital SSM Health St. Joseph Hospital St. Charles SSM Pain Care Services To alleviate chronic pain, SSM Health Pain Care offers a wide range of treatments: Medical management Interventional procedures Surgical options Physical therapy Psychological support Our staff considers various options to develop a treatment plan that achieves the greatest pain relief with the lowest risk. These treatments are often interventional and performed in our office. Epidural steroid injections Other treatments are performed as same-day surgery procedures. Rhizolysis (blocks with radiofrequency energy) Facet joint injections Implantable spinal cord stimulators Discography (for diagnostic use) Implantable medication pumps Kyphoplasty and Vertebroplasty (for vertebral compression fractures) Sacroiliac joint injections Selective nerve root blocks Trigger point injections

12 SSM Health Pain Care Locations SSM Health DePaul Hospital - St. Louis DePaul Drive Suite (North Medical Office Building) St. Louis, Missouri SSM Health St. Clare Hospital - Fenton Bowles Avenue Suite (St. Joseph Building) Fenton, Missouri SSM Health St. Joseph Hospital St. Charles First Capitol Drive St. Charles, Missouri SSM Health St. Joseph Hospital Lake St. Louis Medical Plaza Suite Lake Saint Louis, Missouri SSM Health Outpatient Center 7 Kisker Road Suite St. Charles, Missouri SSM Health St. Joseph Hospital Wentzville 6 Wentzville Parkway, Suite Wentzville, Missouri SSM Health St. Mary s Hospital - St. Louis Bellevue Avenue Suite St. Louis, Missouri For More Information Visit ssmhealth.com/pain for more information and to download a copy of the Pain White Paper. SSM Health has served the St. Louis community for years, and currently has seven hospitals, over physicians, more than physician locations and, employees throughout the area. Recently, all SSM Health hospitals, doctors, home health and other services were brought together under one name. As a result, every St. Louis location is now connected to a wealth of resources, expertise and advanced technology.