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Loftus CG, Ebbert JO, Aakre CA, et al. Creation of a Multispecialty Clinic for Patients with Central Sensitization-Based Chronic Pain Conditions. Mayo Clin Proc Innov Qual Outcomes. 2021;6(1):45-54doi: 10.1016/j.mayocpiqo.2021.11.003.
Loftus, C. G., Ebbert, J. O., Aakre, C. A., Caine, N. A., DeZutter, M. A., Eastman, R. J., Fischer, S. M., Gilman, E. A., Johnson, M. G., Luedtke, C. A., Mohabbat, A. B., Reinschmidt, K. J., Roellinger, D. L., Sanchez, W., & Philpot, L. M. (2022). Creation of a Multispecialty Clinic for Patients with Central Sensitization-Based Chronic Pain Conditions. Mayo Clinic proceedings. Innovations, quality & outcomes, 6(1), 45-54. https://doi.org/10.1016/j.mayocpiqo.2021.11.003
Loftus, Conor G, et al. "Creation of a Multispecialty Clinic for Patients with Central Sensitization-Based Chronic Pain Conditions." Mayo Clinic proceedings. Innovations, quality & outcomes vol. 6,1 (2022): 45-54. doi: https://doi.org/10.1016/j.mayocpiqo.2021.11.003
Loftus CG, Ebbert JO, Aakre CA, Caine NA, DeZutter MA, Eastman RJ, Fischer SM, Gilman EA, Johnson MG, Luedtke CA, Mohabbat AB, Reinschmidt KJ, Roellinger DL, Sanchez W, Philpot LM. Creation of a Multispecialty Clinic for Patients with Central Sensitization-Based Chronic Pain Conditions. Mayo Clin Proc Innov Qual Outcomes. 2021 Dec 23;6(1):45-54. doi: 10.1016/j.mayocpiqo.2021.11.003. eCollection 2022 Feb. PMID: 35005437; PMCID: PMC8715289.
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Mayo Clin Proc Innov Qual Outcomes. 2021 Dec 23;6(1):45-54. doi: 10.1016/j.mayocpiqo.2021.11.003. eCollection 2022 Feb.

Creation of a Multispecialty Clinic for Patients with Central Sensitization-Based Chronic Pain Conditions.

Mayo Clinic proceedings. Innovations, quality & outcomes

Conor G Loftus, Jon O Ebbert, Christopher A Aakre, Natalie A Caine, Meredith A DeZutter, Ryan J Eastman, Stephen M Fischer, Elizabeth A Gilman, Matthew G Johnson, Connie A Luedtke, Arya B Mohabbat, Karen J Reinschmidt, Daniel L Roellinger, William Sanchez, Lindsey M Philpot

Affiliations

  1. Division of Gastroenterology and Hepatology.
  2. Department of Community Internal Medicine.
  3. Division of General Internal Medicine.
  4. Administrative Services.
  5. Department of Medicine.
  6. Kern Center for the Science of Health Care Delivery.
  7. Department of Nursing.
  8. Strategy Department.
  9. Quantitative Health Sciences, Mayo Clinic, Rochester, MN.

PMID: 35005437 PMCID: PMC8715289 DOI: 10.1016/j.mayocpiqo.2021.11.003

Abstract

OBJECTIVE: To design and evaluate, through a human-centered design approach, a multispeciality clinic for patients with central sensitization syndromes that combined virtual previsit consultations, traditional face-to-face appointments, and technology-enabled educational programming.

PATIENTS AND METHODS: Patients with suspected fibromyalgia and chronic abdominal pain were seen in a multispecialty practice, and the performance of the clinic was evaluated against a contemporary cohort. Quantitative and qualitative evaluation measures included team estimates of time spent on care-related tasks, physician rank of alignment of patient need with clinic design, major appointment changes, and nonvisit care tasks. Members of the care team also evaluated strengths, weaknesses, opportunities, and threats to the success of the clinic.

RESULTS: The pilot clinic was operated from April 1, 2020, to April 30, 2021, and included 34 patients with suspected fibromyalgia/chronic abdominal pain. During the pilot period, physicians ranked the value of the virtual previsit consultations in providing care as 7.5 on a scale of 0 to 10 and reported an average of 50 minutes in preparation for the appointment, execution of the appointment, and postvisit documentation. We did not observe substantial differences in the number of added appointments or messages received within the patient portal when compared with a comparison cohort. Patients who participated in the combination nurse educator-led and digital education program provided positive feedback about their experience.

CONCLUSION: Our clinic model provides a framework for the treatment of patients with debilitating centrally sensitized conditions and future expansion of virtual care delivery models to better meet patient care and educational needs.

© 2021 The Authors.

Keywords: C3, complex care coordination; CS, central sensitization; CSS, central sensitization syndrome; FM, fibromyalgia; GSH, guided self-help; IBS, irritable bowel syndrome

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