Authors (including presenting author) :
Wong MC(1), Chan PC(1), Law KL(1), Lee MY(2), Wong YH(3), Lim HS(4)
Affiliation :
(1)KEC Pain Management Centre, (2) Day Surgery Centre,(3)Operating Room, (4)Anaesthesiology and Pain Medicine, United Christian Hospital
Introduction :
New case waiting time of Kowloon East Cluster (KEC) Pain Centre is 156 weeks, the 2rd longest in Hospital Authority’s hospitals. Long waiting time may increase pain intensity and adversely affect co-morbidity of psychiatric illness. Early chronic pain intervention may reduce disability in long term. In 2016, Centre of Disease Control suggested multimodal integrative therapies (MIT) as primary chronic pain intervention. Nurses may provide fast track individual patient assessment and multimodal integrated nursing therapy (MINT) such as modified yoga poses and breathing, meditation, self-massage, guided imagery and chronic pain management general education (40 min/session) in pain nurse clinic (PNC) to empower patient’s chronic pain self-management ability.
Objectives :
1) Compare analgesic consumption and mean differences of pain intensity and Depression, Anxiety and Stress score before 1st and immediate after last MINT 2) Compare medical attendance and hospital admission episodes one year before and after last MINT
Methodology :
This was a retrospective service evaluation. Patients attended KEC PNC for MINT and treatment plan remain unchanged between Aug 2016 and July 2019 was included. Patients attended PNC less than 4 times and received pain management therapy from other disciplines such as pain procedure and physiotherapy were excluded. Patients recruited to pain rehabilitation program immediately after last MINT were excluded for medical attendance and hospital admission analysis. Data was retrieved from patients’ medical record and electronic database.
Result & Outcome :
1) 30 chronic non-cancer pain patients attended PNC and received MINT. There were 11 males, mean age was 47.2+/-13. Mean pain duration and PNC sessions were, 5.4 years and 11.2 sessions (7.5 hours) respectively. 2) Most common pain management modalities used were yoga, self-massage and activity pacing. Common pain cause and condition were injury on duty (n=15, 45.5%) and chronic musculoskeletal pain respectively. 3) There was significant reduction in pain intensity (p< 0.05); anxiety (mild to normal, p< 0.05) and stress (moderate to normal, p< 0.05) level. There was significant improvement in health related quality of life (bodily pain, p< 0.05). 4) Analgesics used were reduced from 83% to 60% (P< 0.05). 5) Attendance of different medical specialties of out-patient and physiotherapy department reduced from 126 to 65 (48.4%) and 215 to 9 (95.8%) visits respectively. Emergency department visit reduced from 10 episodes to zero and number of hospital admission reduced from 6 days to zero. Conclusion MINT reduced pain intensity and improved mood of chronic pain patients, reduced number of hospital admission day, and out-patient and emergency department visit.
