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      Project ECHO Telementoring Intervention for Managing Chronic Pain in Primary Care: Insights from a Qualitative Study

      1 , 2 , 3 , 4 , 5 , 6
      Pain Medicine
      Oxford University Press (OUP)

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          Abstract

          <div class="section"> <a class="named-anchor" id="s1"> <!-- named anchor --> </a> <h5 class="section-title" id="d433970e204">Objective</h5> <p id="d433970e206">Family physicians in Canada receive little training in chronic pain management; concomitantly, they face increasing pressure to reduce their prescribing of opioids. Project ECHO Ontario Chronic Pain/Opioid Stewardship (ECHO) is a telementoring intervention for primary care practitioners that enhances their pain management skills. This qualitative study reports participants’ experiences and assessment of ECHO. </p> </div><div class="section"> <a class="named-anchor" id="s2"> <!-- named anchor --> </a> <h5 class="section-title" id="d433970e209">Design</h5> <p id="d433970e211">An opportunistic sample of multidisciplinary primary care providers attending one of three residential weekend workshops participated in focus group discussions. </p> </div><div class="section"> <a class="named-anchor" id="s3"> <!-- named anchor --> </a> <h5 class="section-title" id="d433970e214">Setting</h5> <p id="d433970e216">University or hospital facilities in Toronto, Thunder Bay, and Kingston, Ontario, Canada. </p> </div><div class="section"> <a class="named-anchor" id="s4"> <!-- named anchor --> </a> <h5 class="section-title" id="d433970e219">Subjects</h5> <p id="d433970e221">Seventeen physicians and 20 allied health professionals.</p> </div><div class="section"> <a class="named-anchor" id="s5"> <!-- named anchor --> </a> <h5 class="section-title" id="d433970e224">Methods</h5> <p id="d433970e226">Six focus group discussions were conducted at three different sites during 2014 and 2015. Transcripts were analyzed using a qualitative-descriptive approach involving analytic immersion in the data, reflection, and achieving consensus around themes discerned from transcribed discussions. </p> </div><div class="section"> <a class="named-anchor" id="s6"> <!-- named anchor --> </a> <h5 class="section-title" id="d433970e229">Results</h5> <p id="d433970e231">Findings resolved into five main themes: 1) challenges of managing chronic pain in primary care; 2) ECHO participation and improvement in patient-provider interaction and participant knowledge; 3) the diffusion of knowledge gained through ECHO to participants’ colleagues and patients; 4) ECHO participation generating a sense of community; and 5) disadvantages associated with participating in ECHO. </p> </div><div class="section"> <a class="named-anchor" id="s7"> <!-- named anchor --> </a> <h5 class="section-title" id="d433970e234">Conclusions</h5> <p id="d433970e236">Managing patients with chronic pain in primary care can be difficult, particularly in remote or underserved practices. Project ECHO offers guidance to primary care practitioners for their most challenging patients, promotes knowledge acquisition and diffusion, and stimulates the development of a “community of practice.” </p> </div>

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          Author and article information

          Journal
          Pain Medicine
          Oxford University Press (OUP)
          1526-2375
          1526-4637
          June 2018
          June 01 2018
          September 27 2017
          June 2018
          June 01 2018
          September 27 2017
          : 19
          : 6
          : 1140-1146
          Affiliations
          [1 ]Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
          [2 ]Outpatient Services -Project ECHO, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
          [3 ]Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada
          [4 ]Department of Physical Medicine and Rehabilitation, Queen’s University, Kingston, Ontario, Canada
          [5 ]The Tweed Hospital, University of New South Wales, Sydney, New South Wales, Australia
          [6 ]Department of Medicine, Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
          Article
          10.1093/pm/pnx233
          5998945
          29036381
          9fc555aa-2567-4b21-8b5e-0aab7de24d4e
          © 2017

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