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Original research
Accessing care in multidisciplinary pain treatment facilities continues to be a challenge in Canada
  1. Manon Choinière1,2,
  2. Philip Peng3,4,
  3. Ian Gilron5,6,
  4. Norman Buckley7,8,
  5. Owen Williamson9,10,
  6. Audree Janelle-Montcalm2,
  7. Krista Baerg11,12,
  8. Aline Boulanger1,13,
  9. Tania Di Renna14,15,
  10. Gordon Allen Finley16,17,
  11. Howard Intrater18,19,
  12. Brenda Lau20,21 and
  13. John Pereira22,23
  1. 1Department of Anesthesiology and Pain Medicine, Université de Montréal Faculté de Médecine, Montreal, Quebec, Canada
  2. 2Research Center, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada
  3. 3Anesthesiology and Pain Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
  4. 4Anesthesiology, University Health Network—Western Hospital, Toronto, Ontario, Canada
  5. 5Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada
  6. 6Anesthesiology, Kingston General Hospital, Kingston, Ontario, Canada
  7. 7Anestheiology, Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
  8. 8Michael F. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
  9. 9Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  10. 10JPOCSC Pain Management Clinic, Fraser Health Authority, Surrey, British Columbia, Canada
  11. 11Pediatrics, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
  12. 12Pediatrics, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
  13. 13Pain Clinic, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
  14. 14Department of Anesthesiology and Pain Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
  15. 15Anesthesiology, Women's College Hospital, Toronto, Ontario, Canada
  16. 16Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
  17. 17Center for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada
  18. 18Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
  19. 19Pain Clinic, Health Sciences Centre, Winnipeg, Manitoba, Canada
  20. 20Pain Medicine, Department of Anesthesia, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
  21. 21CHANGEpain Clinic, Vancouver, Quebec, Canada
  22. 22Family Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  23. 23Calgary Chronic Pain Center, Alberta Health Services, Edmonton, Alberta, Canada
  1. Correspondence to Dr Manon Choinière, Department of Anesthesiology and Pain Medicine, Université de Montréal Faculté de Médecine, Montreal, QC H3T 1J4, Canada; manon.choiniere{at}umontreal.ca

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.

  • chronic pain
  • outcome assessment
  • health care
  • pain management

https://doi.org/10.1136/rapm-2020-101935

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    Footnotes

    • Twitter @DrODWilliamson, @kbaerg

    • Contributors MC and PP: study design/planning; acquisition, analysis and interpretation of results; manuscript preparation and review. IG, NB, OW, and AJ-M: acquisition, analysis and interpretation of results; manuscript review. KB, AB, TDR, GAF, HI and JP acquisition, analysis, and interpretation of results; manuscript review.

    • Funding This study was funded by the Chronic Pain Network through the Strategy for Patient-Oriented Research (grant # SCA-145102), an initiative of the Canadian Institutes of Health Research.

    • Disclaimer The funding contributor had no role in the design and conduct of the study; the collection, management, analysis or interpretation of the data; the preparation, review or approval of the manuscript; or the decision to submit the manuscript for publication.

    • Competing interests KB receives royalties from Brush Education for the book "Teamwork, Leadership, and Communication: Collaboration Basics for Health Professionals."

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by the Research Ethics Board of the Centre hospitalier de l’Université de Montréal.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on reasonable request.