Evaluation of a multidisciplinary outpatient pain management programme based at a community hospital

Wong, Mei Yin; Rietzschel, Julia; Mulherin, D.; David, Carol

doi:10.1002/msc.147

Cited by 9 publications

(7 citation statements)

References 37 publications

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“…Community hospitals provide a wide range of services, covering the whole spectrum of care provision, from preventative [2021] and primary care [2223], through to outpatient services [242526], inpatient medical care [2728], surgery [2930], minor injury [31] and accident and emergency care [2232]. Within these broad areas, there was considerable diversity of the types of services provided, and a number of studies further reported on the implementation of new and innovative types and methods of service provision not previously available within the community hospital setting, such as point-of-care testing [23], fracture clinics [33] or chemotherapy [34].…”

Section: Resultsmentioning

confidence: 99%

Community Hospitals in Selected High Income Countries: A Scoping Review of Approaches and Models

Winpenny¹,

Corbett²,

Miani³

et al. 2016

International Journal of Integrated Care

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Background:There is no single definition of a community hospital in the UK, despite its long history. We sought to understand the nature and scope of service provision in community hospitals, within the UK and other high-income countries.Methods:We undertook a scoping review of literature on community hospitals published from 2005 to 2014. Data were extracted on features of the hospital model and the services provided, with results presented as a narrative synthesis.Results:75 studies were included from ten countries. Community hospitals provide a wide range of services, with wide diversity of provision appearing to reflect local needs. Community hospitals are staffed by a mixture of general practitioners (GPs), nurses, allied health professionals and healthcare assistants. We found many examples of collaborative working arrangements between community hospitals and other health care organisations, including colocation of services, shared workforce with primary care and close collaboration with acute specialists.Conclusions:Community hospitals are able to provide a diverse range of services, responding to geographical and health system contexts. Their collaborative nature may be particularly important in the design of future models of care delivery, where emphasis is placed on integration of care with a key focus on patient-centred care.

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Section: Resultsmentioning

confidence: 99%

Community Hospitals in Selected High Income Countries: A Scoping Review of Approaches and Models

Winpenny¹,

Corbett²,

Miani³

et al. 2016

International Journal of Integrated Care

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“…Community hospitals provide a wide range of services, across a broad spectrum of care provision, from preventative 38,39 and primary care 40,41 through to outpatient services, [42][43][44] inpatient medical care, 21,45 surgery, 46,47 minor injury care 48 and accident and emergency (A&E) care. 40,49 Within these broad areas, there was considerable diversity of the types of services provided, and a number of studies further reported on the implementation of new types and methods of service provision not previously available within the community hospital setting, such as point-of-care testing, 41 fracture clinics 50 or chemotherapy.…”

Section: Range Of Services Provided By Community Hospitalsmentioning

confidence: 99%

Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies

Pitchforth

Nolte

Corbett

et al. 2017

Health Serv Deliv Res

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BackgroundThe notion of a community hospital in England is evolving from the traditional model of a local hospital staffed by general practitioners and nurses and serving mainly rural populations. Along with the diversification of models, there is a renewed policy interest in community hospitals and their potential to deliver integrated care. However, there is a need to better understand the role of different models of community hospitals within the wider health economy and an opportunity to learn from experiences of other countries to inform this potential.ObjectivesThis study sought to (1) define the nature and scope of service provision models that fit under the umbrella term ‘community hospital’ in the UK and other high-income countries, (2) analyse evidence of their effectiveness and efficiency, (3) explore the wider role and impact of community engagement in community hospitals, (4) understand how models in other countries operate and asses their role within the wider health-care system, and (5) identify the potential for community hospitals to perform an integrative role in the delivery of health and social care.MethodsA multimethod study including a scoping review of community hospital models, a linked systematic review of their effectiveness and efficiency, an analysis of experiences in Australia, Finland, Italy, Norway and Scotland, and case studies of four community hospitals in Finland, Italy and Scotland.ResultsThe evidence reviews found that community hospitals provide a diverse range of services, spanning primary, secondary and long-term care in geographical and health system contexts. They can offer an effective and efficient alternative to acute hospitals. Patient experience was frequently reported to be better at community hospitals, and the cost-effectiveness of some models was found to be similar to that of general hospitals, although evidence was limited. Evidence from other countries showed that community hospitals provide a wide spectrum of health services that lie on a continuum between serving a ‘geographic purpose’ and having a specific population focus, mainly older people. Structures continue to evolve as countries embark on major reforms to integrate health and social care. Case studies highlighted that it is important to consider local and national contexts when looking at how to transfer models across settings, how to overcome barriers to integration beyond location and how the community should be best represented.LimitationsThe use of a restricted definition may have excluded some relevant community hospital models, and the small number of countries and case studies included for comparison may limit the transferability of findings for England. Although this research provides detailed insights into community hospitals in five countries, it was not in its scope to include the perspective of patients in any depth.ConclusionsAt a time when emphasis is being placed on integrated and community-based care, community hospitals have the potential to assume a more strategic role in health-care delivery locally, providing care closer to people’s homes. There is a need for more research into the effectiveness and cost-effectiveness of community hospitals, the role of the community and optimal staff profile(s).FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…d = 1 13 compare favourably with these values. With regard to healthcare utilisation, Wong et al 66 found a significant reduction in pain-related GP visits following a multidisciplinary CBT PMP ( . , . )…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Brief cognitive analytic therapy for adults with chronic pain: a preliminary evaluation of treatment outcome

Baronian

Leggett

2019

British Journal of Pain

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Background: Cognitive analytic therapy (CAT) has diversified in its application to a broad range of presenting difficulties and formats and there has been growing interest in its use in clinical health settings including Pain Management Services. Despite its growing popularity, to date, no studies have examined the application of CAT for chronic pain. Aims: The purpose of this study was to examine the effectiveness of time-limited, individual CAT for adults with chronic pain as delivered in a publicly funded Community Pain Management Service. Methods: This was an observational service evaluation of treatment practice within a routine clinical setting. Participants were 53 adults with chronic pain who completed eight sessions of individual therapy. Individual and group-level outcomes on self-reported distress, pain-related self-efficacy, as well as changes in healthcare utilisation pre- and post-intervention were examined. Results: Large pre–post effects on wellbeing ( d = 1.50) and self-efficacy ( d = 1.13) were observed, while effects on healthcare utilisation were medium to large ( d = 0.67). Moreover, reliable change and clinical significance analyses demonstrated that results were clinically meaningful. The majority of clients (67.9%) showed reliable improvement following the CAT intervention and 28% achieved both reliable and clinically significant improvements in psychological distress. Approximately 4 of 10 clients (43.5%) showed reliably higher perceived self-efficacy at the end of therapy. Conclusion: The results of this evaluation suggest that brief CAT is an encouraging intervention for adults with persistent pain. While preliminary, our findings provide support for a brief approach to persistent pain that focuses not on controlling or eliminating pain but on elucidating and revising unhelpful relational patterns that may impinge upon one’s pain management. Directions for future research are suggested.

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Evaluation of a multidisciplinary outpatient pain management programme based at a community hospital

Abstract: The result of the evaluation indicated that this PMP, delivered in a community hospital setting, made some significant differences to patients with intractable chronic pain conditions.

Cited by 9 publications

References 37 publications

Community Hospitals in Selected High Income Countries: A Scoping Review of Approaches and Models

Community Hospitals in Selected High Income Countries: A Scoping Review of Approaches and Models

Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies

Brief cognitive analytic therapy for adults with chronic pain: a preliminary evaluation of treatment outcome

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