Eventbrite - Chronic Pain Study II: Integrative Health Group 6 Week Pilot Program

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Integrative Health Group Visits (IHGV): A Pilot Feasibility Study to Manage People with Chronic Pain in a Nordic Inner-City Medical Clinic
Noble-Letort SR; Appa RS; Bangsgaard K

Background:

Chronic pain is a condition that 75% of North American highly esteemed academic medical centers and affiliate institutions practicing integrative medicine, report the most clinical success[1]. Increasingly, evidence suggests that Integrative Health and Medicine (IHM) visits are effective for treating chronic pain; similarly, a number of studies demonstrate the effectiveness of certain evidence-based complementary therapies in managing pain.

Objectives:

The primary goal of this 2017 study is to evaluate the feasibility of the integrative health group visit (IHGV) care model in a Nordic inner-city outpatient medical clinic. IHGV combines patient-centered, non-pharmacologic strategies that complement pharmacological treatments and incorporate the principles of National Institute of Health / National Center for Complementary and Integrative Health (NIH NCCIH) recommended therapies for the management of chronic pain and associated symptoms.

We will survey groups of people, pre and post, who will each undergo a 6 week/8-session IHGV program (5 – 6 groups; median 12 people/group; range 8-16 participants) over the course of 12 months to evaluate qualitative changes in pain (0-10 point scale and Autonomic Symptoms Questionnare), sleep quality and co-morbid symptoms as well as perceived stress, anxiety and depression (Patient Health Questionaire 15 [PHQ-15] Hospital Anxiety and Depression Scale [HADS]).

Proposed Results and Conclusion:

Based on the overall findings of the 2016 NIH NCCIH / Mayo Clinic Review of 150 Randomized Control Trials (RCT) investigating Complementary Approaches to Pain, as well as the Boston Medical Center (BMC) Integrative Medicine Group Visit (IMGV) 2014 study, we now propose a similarly inspired interventional pilot study to begin a process to determine effectiveness and feasibility in the Nordic region. The 2014 IMGV study, which combined both conventional and integrative medicine therapies, enrolled 65 (93%) out of 75 people in the study. Over the course of 12 months, 7 groups met (median 9 patients/group; range 8-13 participants). Mean difference in pain level for all patients between baseline and 8 weeks was 0.7 (SD=2.0, P=.005). Mean difference in PHQ-8 depression score for patients with baseline score ≥5 was 2.6 (SD=4.6, P<.001). In addition, statistically significant improvements were also seen in sleep quality and perceived stress.

Key Words:

Group medical visit, patient-centered non-pharmacologic strategies, chronic pain, Integrative Health Group Visits (IHGV), National Institute of Health (NIH), National Center for Complementary and Integrative Health (NCCIH), Integrative Medicine Group Visits (IMGV), Integrative Health and Medicine (IHM)

[1] Integrative Medicine in America: How Integrative Medicine is Being Practiced in Clinical Centers Across the United States, The Bravewell Collaborative, 2012, page 34