Accessing care in multidisciplinary pain treatment facilities continues to be a challenge in Canada

Manon Choinière; Philip Peng; Ian Gilron; Norman Buckley; Owen Williamson; Audree Janelle-Montcalm; Krista Baerg; Aline Boulanger; Tania Di Renna; Gordon Allen Finley; Howard Intrater; Brenda Lau; John Pereira

doi:10.1136/rapm-2020-101935

Accessing care in multidisciplinary pain treatment facilities continues to be a challenge in Canada

Reg Anesth Pain Med. 2020 Dec;45(12):943-948. doi: 10.1136/rapm-2020-101935. Epub 2020 Oct 6.

Authors

Manon Choinière^{1

2}, Philip Peng^{3

4}, Ian Gilron^{5

6}, Norman Buckley^{7

8}, Owen Williamson^{9

10}, Audree Janelle-Montcalm², Krista Baerg^{11

12}, Aline Boulanger^{13

14}, Tania Di Renna^{15

16}, Gordon Allen Finley^{17

18}, Howard Intrater^{19

20}, Brenda Lau^{21

22}, John Pereira^{23

24}

Affiliations

¹ Department of Anesthesiology and Pain Medicine, Université de Montréal Faculté de Médecine, Montreal, Quebec, Canada manon.choiniere@umontreal.ca.
² Research Center, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada.
³ Anesthesiology and Pain Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
⁴ Anesthesiology, University Health Network-Western Hospital, Toronto, Ontario, Canada.
⁵ Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.
⁶ Anesthesiology, Kingston General Hospital, Kingston, Ontario, Canada.
⁷ Anestheiology, Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
⁸ Michael F. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada.
⁹ Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
¹⁰ JPOCSC Pain Management Clinic, Fraser Health Authority, Surrey, British Columbia, Canada.
¹¹ Pediatrics, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada.
¹² Pediatrics, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada.
¹³ Department of Anesthesiology and Pain Medicine, Université de Montréal Faculté de Médecine, Montreal, Quebec, Canada.
¹⁴ Pain Clinic, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
¹⁵ Department of Anesthesiology and Pain Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
¹⁶ Anesthesiology, Women's College Hospital, Toronto, Ontario, Canada.
¹⁷ Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada.
¹⁸ Center for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada.
¹⁹ Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada.
²⁰ Pain Clinic, Health Sciences Centre, Winnipeg, Manitoba, Canada.
²¹ Pain Medicine, Department of Anesthesia, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada.
²² CHANGEpain Clinic, Vancouver, Quebec, Canada.
²³ Family Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
²⁴ Calgary Chronic Pain Center, Alberta Health Services, Edmonton, Alberta, Canada.

PMID: 33024007
DOI: 10.1136/rapm-2020-101935

Abstract

Background: Multidisciplinary pain treatment facilities (MPTFs) are considered the optimal settings for the management of chronic pain (CP). This study aimed (1) to determine the distribution of MPTFs across Canada, (2) to document time to access and types of services, and (3) to compare the results to those obtained in 2005-2006.

Methods: This cross-sectional study used the same MPTF definition as in 2005-2006-that is, a clinic staffed with professionals from a minimum of three different disciplines (including at least one medical specialty) and whose services were integrated within the facility. A comprehensive search strategy was used to identify existing MPTFs across Canada. Administrative leads at each MPTF were invited to complete an online questionnaire regarding their facilities.

Results: Questionnaires were completed by 104 MPTFs (response rate 79.4%). Few changes were observed in the distribution of MPTFs across Canada compared with 12 years ago. Most (91.3%) are concentrated in large urban cities. Prince Edward Island and the Territories still lack MPTFs. The number of pediatric-only MPTFs has nearly doubled but remains small (n=9). The median wait time for a first appointment in publicly funded MPTFs is about the same as 12 years ago (5.5 vs 6 months). Small but positive changes were also observed.

Conclusion: Accessibility to public MPTFs continues to be limited in Canada, resulting in lengthy wait times for a first appointment. Community-based MPTFs and virtual care initiatives to distribute pain services into regional and remote communities are needed to provide patients with CP with optimal care.

Keywords: chronic pain; health care; outcome assessment; pain management.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Canada
Child
Chronic Pain* / diagnosis
Chronic Pain* / epidemiology
Chronic Pain* / therapy
Cross-Sectional Studies
Health Services Accessibility
Humans
Pain Management*
Surveys and Questionnaires