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Wile KA, Roy S, Stuckey H, Zimmerman E, Bailey D, Parascando JA, Reedy-Cooper A. Qualitative Needs Assessment for the Development of Chronic Pain Group Medical Visits. J Patient Exp 2021; 8:23743735211063122. [PMID: 34869851 PMCID: PMC8640981 DOI: 10.1177/23743735211063122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Group medical visits (GMVs) for patients with chronic pain are becoming more accessible and have been shown to be successful in furthering patient education on multidisciplinary, nonopioid interventions. Unfortunately, evidence suggests that many group visit models lack sustainability due to recruitment issues and retention rates. Additionally, most of the studies surrounding GMVs are located in primarily urban health centers, potentially limiting their generalizability. This study aims to identify patient interest in and barriers to GMVs for chronic pain and to explore how chronic pain impacts daily lives for GMV content optimization in a nonurban population. Nineteen participants age 18 to 65 years participated in semistructured phone interviews to generate a thematic analysis. Participants received their care from family practitioners at a suburban multiclinic academic medical group and were being prescribed at least 50 morphine milligram equivalents (MME) at the time of recruitment. Analysis generated two themes: (1) Participants expressed specific interest in GMVs with few barriers identified, and (2) Pain has a negative impact on mental health and most aspects daily life, creating a foundation for discussion in GMVs. Findings support significant patient interest in group medical visits for chronic pain, but careful planning is necessary to address patient needs, expectations, and barriers in order to ensure GMV sustainability.
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Affiliation(s)
- Kevin A Wile
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Siddhartha Roy
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Heather Stuckey
- Department of Medicine, Penn State College of Medicine, Hershey, PA, USA
| | | | - David Bailey
- Penn State College of Medicine, Hershey, PA, USA
| | - Jessica A Parascando
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Alexis Reedy-Cooper
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, USA
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Shah MK, Gibbs AC, Ali MK, Narayan KMV, Islam N. Overcoming the Digital Divide in the Post-COVID-19 "Reset": Enhancing Group Virtual Visits with Community Health Workers. J Med Internet Res 2021; 23:e27682. [PMID: 34152995 PMCID: PMC8274676 DOI: 10.2196/27682] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/12/2021] [Accepted: 06/14/2021] [Indexed: 01/13/2023] Open
Abstract
The COVID-19 pandemic created numerous barriers to the implementation of participant-facing research. For most, the pandemic required rapid transitioning to all virtual platforms. During this pandemic, the most vulnerable populations are at highest risk of falling through the cracks of engagement in clinical care and research. Nonetheless, we argue that we should reframe the discussion to consider how this transition may create opportunities to engage extensively to reach populations. Here, we present our experience in Atlanta (Georgia, United States) in transitioning a group visit model for South Asian immigrants to a virtual platform and the pivotal role community members in the form of community health workers can play in building capacity among participants. We provide details on how this model helped address common barriers to group visit models in clinical practice and how our community health worker team innovatively addressed the digital challenges of working with an elderly population with limited English proficiency.
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Affiliation(s)
- Megha K Shah
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Dunwoody, GA, United States
| | - Ashley Christina Gibbs
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Dunwoody, GA, United States
| | - Mohammed K Ali
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Dunwoody, GA, United States.,Hubert Department of Global Health, Emory Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - K M Venkat Narayan
- Hubert Department of Global Health, Emory Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Nadia Islam
- Division of Population Health, Grossman School of Medicine, New York University, New York City, NY, United States
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Tataryn A, Derbowka H, Shen X, Gage E, Kang E, Wlock J, Lieffers J. A Qualitative Evaluation of Patient Experiences With Group Medical and Individual Education Appointments for Type 2 Diabetes Management in Saskatchewan, Canada. DIABETES EDUCATOR 2020; 46:261-270. [PMID: 32228289 DOI: 10.1177/0145721720913278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to capture information on patient experiences and perspectives of group medical appointments (GMAs) and compare them to those attending individual appointments (IAs) with the diabetes education team (usual care) for managing type 2 diabetes. METHODS Adults (N = 18; 61% male; 83% 50-70 years old ) with type 2 diabetes (or prediabetes) living in rural Saskatchewan were recruited to complete a semistructured interview on their experiences with GMAs or IAs. To be eligible to participate, individuals must have attended at least 2 GMAs or 2 IAs. Transcripts were coded and analyzed using content analysis. RESULTS Overall, participants spoke highly of their respective appointment type. Results indicated that both appointment types positively influenced understanding of diabetes management, with the most notable difference being greater understanding of stress management in the GMAs. Participants identified several positive aspects of each appointment type, which included convenience, supportive and enjoyable, and informative for GMAs and time and tailored information for IAs. Participants provided some suggestions to improve diabetes related-care for their respective appointment type. CONCLUSIONS Participants of GMAs and IAs for type 2 diabetes each reported unique strengths to their respective care plan and reported benefiting from their care.
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Affiliation(s)
- Anna Tataryn
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Hannah Derbowka
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Xinyu Shen
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Emily Gage
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ester Kang
- Nutrition and Food Services, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
| | - Jillian Wlock
- Sunrise Health and Wellness Centre, Saskatchewan Health Authority, Yorkton, Saskatchewan, Canada
| | - Jessica Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Abstract
PURPOSE OF REVIEW Community health centers (CHCs) provide care to millions of vulnerable patients in the USA, including a disproportionate number with diabetes. Policies affecting diabetes management in CHCs therefore have broad implications for clinical practice and patient outcomes nationwide. We describe prior policies that have influenced diabetes management in CHCs, discuss current policies and programs, as well as present emerging innovations and future directions for diabetes care in this setting. RECENT FINDINGS Domains for current diabetes policies and programs in CHCs include coverage requirements, quality reporting and incentives, prescription discounts, healthy behavior incentives, and team-based care. Policies in these areas affect the management of diabetes at multiple levels, from organizations that support CHCs to individual health centers, and the providers and patients based there. Several domains of interrelated policies and programs impact CHC diabetes management at multiple levels. Stakeholders' understanding of these policies and programs may identify opportunities to improve diabetes care.
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Affiliation(s)
- A Taylor Kelley
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, 50 North Medical Dr. 5R341, Salt Lake City, UT, 84132, USA.
- Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.
| | - Robert S Nocon
- Department of Medicine, Section of General Internal Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Matthew J O'Brien
- Department of Internal Medicine, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Thompson-Lastad A, Gardiner P, Chao MT. Integrative Group Medical Visits: A National Scoping Survey of Safety-Net Clinics. Health Equity 2019; 3:1-8. [PMID: 30706043 PMCID: PMC6352502 DOI: 10.1089/heq.2018.0081] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: Integrative group medical visits (IGMVs) aim to increase access to complementary and integrative health care, which is particularly relevant for low-income people. We sought to describe IGMV programs in US safety-net clinics through a survey of providers. Methods: An online and paper survey was conducted to collect data on the use of complementary health approaches and characteristics of IGMV programs. We recruited a purposive sample of safety-net clinicians via national meetings and listservs. Results: Fifty-seven clinicians reported on group medical visits. Forty percent worked in federally qualified health centers, 57% in safety-net or teaching hospitals, 23% in other settings such as free clinics. Thirty-seven respondents in 11 states provided care in IGMVs, most commonly for chronic pain and diabetes. Nutrition (70%), mindfulness/meditation/breathing (59%), and tai chi/yoga/other movement practices (51%) were the most common treatment approaches in IGMVs. Conclusion: Safety-net institutions in 11 states offered IGMVs to treat a range of chronic conditions. IGMVs are an innovative model to improve access to non-pharmacologic approaches to chronic illness care and health promotion. They may advance health equity by serving patients negatively impacted by health and health care disparities.
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Affiliation(s)
| | - Paula Gardiner
- Department of Family Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Maria T. Chao
- Division of General Internal Medicine and Osher Center for Integrative Medicine, UC San Francisco, San Francisco, California
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