Redefining Chronic Pain Care Delivery - One Group at a Time

Irina Todorov, Wellness & Preventive Medicine, Cleveland Clinic, USA

Background: Chronic pain affects 100 million Americans (more than heart disease, diabetes and cancer combined). Recent guidelines from the American College of Physicians recommend initially to select non-pharmacological treatment with multidisciplinary approach, stress reduction, yoga or spinal manipulation before considering pharmacologic treatment for chronic low back pain. In 2018 Joint Commission issued new advisory in which concluded that not all pain management requires medication and the evidence based, non-opioid treatment options like behavioral, environmental-based and manual interventions were highlighted as treatment options for chronic pain.

Objective: The Center for Integrative and Lifestyle Medicine at Cleveland Clinic developed group medical visits for chronic pain management which address diverse drivers of chronic pain using nutrition education, acupuncture, massage, chiropractic care, and stress relief techniques like meditation and yoga.

Methods: Effectiveness of this approach was evaluated using the PROMIS-57 questionnaire and pain scale on the first and last visit. Only patient with full data set were included in reported results.

Results: Preliminary data from 106 patients show that more than 50% of participants report significant reductions in pain interference, pain intensity, anxiety, depression, fatigue and sleep disturbance, as well as significant increases in physical functioning and social satisfaction at the end of the treatment.

Conclusion: Integrative Medicine Group Medical Visits combining evidence-based non-pharmacological treatments delivered by interdisciplinary team of healthcare professionals may represent an optimal way of treatment for patients with chronic pain