Abstract
177 - Integrating Two Non-Pharmacologic Pain Management Strategies for Musculoskeletal Pain in Primary Care Settings
The journal of pain, Vol.29(Supplement), 104975
04/2025
DOI: 10.1016/j.jpain.2025.104975
Abstract
The Centers for Disease Control and Prevention (CDC) Clinical Practice Guideline for Prescribing Opioids for Pain advocates for non-pharmacological treatment for chronic pain. However, the adoption, documentation, and implementation of these guidelines in clinical practice are hindered by gaps in primary care clinic resources and workflows. Two effective non-pharmacological approaches for managing chronic pain are exercise and transcutaneous electrical nerve stimulation (TENS), both of which have also been shown to reduce opioid usage. Here, we present the results of implementing the Bundle for Exercises and TENS (BEsT). This model was designed to facilitate the prescription of exercise and TENS as part of an individualized care plan. Our primary objective was to assess the effectiveness of BEsT in treating patients with chronic musculoskeletal pain in three primary care clinics. Control charts were developed to track provider behaviors in prescribing opioids, non-opioid analgesics, TENS, exercise, and physical/occupational therapy (PT/OT) referrals. Surveys capturing provider perceptions were conducted, along with summative focus groups. Control charts revealed statistically significant changes in the prescription rates of TENS, exercise, and opioids in two out of three clinics. The maximum prescription rate for TENS increased from 4% to 20%, and for exercise from 0% to 13% during the training period. Across all clinics, opioid prescriptions decreased from 26% to 14%. Providers identified several key advantages of BEsT, including the auto-populate feature, the availability of patient education materials, and the reduction in opioid use. However, they also noted disadvantages, such as increased time and staff burdens and workflow disruptions.
Details
- Title: Subtitle
- 177 - Integrating Two Non-Pharmacologic Pain Management Strategies for Musculoskeletal Pain in Primary Care Settings
- Creators
- Carol GT VanceDana L DaileyLynn NakadDavid A KatzNicholas R ButlerStacey AppenheimerStephanie H Gilbertson-WhiteJennie EmbreeSandra E Daack-HirschKathleen A SlukaBarbara A Rakel
- Resource Type
- Abstract
- Publication Details
- The journal of pain, Vol.29(Supplement), 104975
- Publisher
- Elsevier Inc; EDINBURGH
- DOI
- 10.1016/j.jpain.2025.104975
- ISSN
- 1526-5900
- eISSN
- 1528-8447
- Language
- English
- Date published
- 04/2025
- Academic Unit
- Epidemiology; Iowa Neuroscience Institute; Family and Community Medicine; Nursing; Physical Therapy and Rehabilitation Science; Fraternal Order of Eagles Diabetes Research Center; Neuroscience and Pharmacology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984821351802771
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