Maintaining Access to an Interdisciplinary Pain Program During COVID-19

Abstract

\n Research Objectives\n 1. To compare patient attendance in an interdisciplinary pain program (IPP) before and during the COVID-19 pandemic. 2. To describe programmatic changes in response to patient needs during the pandemic.\n \n Design\n Cohort comparison of IPP attendance rates before versus during the pandemic.\n \n Setting\n Outpatient IPP (consisting of physical therapy [PT], cognitive behavioral therapy [CBT], and medication management [MM]) within an academic medical center.\n \n Participants\n Adults diagnosed with chronic pain (N=259) who attended ≥ 1 IPP session between March 2017 and February 2020.\n \n Interventions\n Before COVID-19, PT, CBT, and MM delivered in-person. During COVID-19, PT and MM delivered remotely and in person; CBT delivered via telehealth to individuals and groups to allow social distance and respond to facial affect.\n \n Main Outcome Measures\n Objective 1. Patient attendance\u202f=\u202fattending ≥ 6 days of PT or CBT (individual and/or group).\n \n Results\n Objective 1. Before COVID-19, IPP attendance (from 3/20/2017 to 3/4/2020) was 76%. Since COVID-19 and through 2/2021, attendance was 65%. Objective 2: During COVID-19, PT included both telehealth and masked, in-person sessions. CBT was delivered through telehealth. IPP psychologist s role grew to promote evidence-based nonpharmacologic intervention for COVID-19 and reduce vaccination hesitation.\n \n Conclusions\n Overall, IPP clinicians and staff maintained safe access to interdisciplinary care for adults with chronic pain. Despite the global pandemic 65% of the patients completed the IPP. The 11% reduction in attendance may reflect increased biopsychosocial burdens experienced by patients with chronic pain during COVID-19. As chronic pain affects more Americans than diabetes, heart disease, and cancer combined, future studies are needed to identify the barriers to attendance among patients before and after COVID-19. Determining how to best reduce the risk of attrition will assist patients in benefiting fully from IPP treatment.\n \n Author(s) Disclosures\n None related to this project.\n