Transition to Virtual Care Services during COVID-19 at Canadian Pain Clinics: Survey and Future Recommendations

Abstract

Introduction. Due to the COVID-19 pandemic, healthcare centers quickly adapted services into virtual formats. Pain clinics in Canada play a vital role in helping people living with pain, and these clinics remained essential services for patients throughout the pandemic. This study aimed to (1) describe and compare the transition from in-person to virtual pain care services at Canadian pain clinics during the onset of the COVID-19 pandemic and (2) provide postpandemic recommendations for pain care services to optimize the quality of patient care. Materials and Methods. We used a qualitative participatory action study design that included a cross-sectional survey for data collection and descriptive analysis to summarize the findings. Survey responses were collected between January and March of 2021. The survey was administered to the leadership teams of 11 adult pain clinics affiliated with the Chronic Pain Centre of Excellence for Canadian Veterans. Responses were analyzed qualitatively to describe the transition to the virtual pain services at pain clinics. Results. We achieved a 100% response rate from participating clinics. The results focus on describing the transition to the virtual care, current treatment and services, the quality of care, program sustainability, barriers to maintaining virtual services, and future considerations. Conclusions. Participating clinics were capable of transitioning pain care services to the virtual formats and have in-person care when needed with proper safety precautions. The pandemic demonstrated that it is feasible and sustainable for pain clinics to have a hybrid of virtual and in-person care to treat those living with pain. It is recommended that moving forward, there should be a hybrid of both virtual and in-person care for pain clinics. Ministries of Health should continue to develop policies and funding mechanisms that support innovations aimed at holistic healthcare, interdisciplinary teams, and the expansion of clinics’ geographical reach for patient access.

Physician perspectives on chronic pain management: barriers and the use of eHealth in the COVID-19 era

“…Additionally, despite the promise that eHealth technology holds for addressing several of the current barriers identified, particularly amidst the COVID-19 pandemic, adoption rates remain low. Improved design, awareness, funding, and training are required to achieve successful implementation of eHealth technology [98] . As we move through the fourth year of the COVID-19 pandemic, there exists no better time for governments, front-line workers and software developers to work collaboratively to determine how to best integrate eHealth tools into standard practice.…”

“…Lastly, the findings offer a reminder that modified or non-technology options are still required for certain patient populations, such as those with cognitive limitations or without internet access. For example, in Canada, there are large variations in who has internet access [98]. Specifically, the most recent Canadian data indicate that 98.6% of households in urban areas are able to access broadband internet services, compared to just 45.6% in rural households and 34.8% in First Nation reserves [99].…”

The Calm after the Storm: A State-of-the-Art Review about Recommendations Put Forward during the COVID-19 Pandemic to Improve Chronic Pain Management

“…Also, a communication of trust is more difficult to establish with healthcare professionals [9,57]. One Canadian study reported that nearly 15% of patients were not well equipped to receive virtual care [58]. Despite some accessibility challenges, the development of effective non-pharmacological treatments delivered virtually may be essential during any future pandemic, especially when lockdowns are in place.…”

“…Despite some accessibility challenges, the development of effective non-pharmacological treatments delivered virtually may be essential during any future pandemic, especially when lockdowns are in place. Many multidisciplinary pain treatment facilities in Canada are now well prepared to deliver virtual care and consider virtual care to be sustainable for any future pandemic and well beyond [58]. It is also a good opportunity for healthcare professionals to reinforce the utility of effective non-pharmacological treatment options and their benefits in pain management [29].…”

“…It is also a good opportunity for healthcare professionals to reinforce the utility of effective non-pharmacological treatment options and their benefits in pain management [29]. The COVID-19 pandemic developments have accelerated the adoption of virtual care and have brought huge benefits (e.g., cost saving for patients [59], improved access and efficiency [60], and greater geographical reach for clinicians [58]), even while still being a work in progress [61].…”