Second Project in Lab: MDC (pt. 1)

View this project as a published paper here.

For my Signature portfolio posts of March, I will be describing the second project I worked on in the Pilitsis lab. I started work on this project in late July-early August 2021, but it was not published until late November 2021.

In an earlier post, I defined chronic pain by using the example of having chronic leg pain in my left leg. I described possible treatment approaches, such as taking Advil, visiting my pediatrician, or going to physical therapy. However, these treatment options were not successful.

Chronic pain treatment can be expensive and ineffective. Frequent visits to primary care physicians (in my example, this could be applied to my visits to my pediatrician) and emergency departments. These repetitive visits are directly linked to physician burnout, as primary care doctors are not trained to treat chronic pain. This results in disappointment and a sense of helplessness on both ends as there is a lack of improvement. Often, patients will be prescribed non-opioid or opioid medication. Opioids are highly addictive, and the use of opioids has quadrupled since the 1990s, despite their limited effectiveness. Treatment methods such as physical therapy, yoga, or core strength training do not produce immediate results and can leave patients feeling frustrated. Lastly, invasive procedures such as neuromodulation (remember the last project on SCS?) or surgery are costly and come with their own risks (such as infection). Patients who utilize these treatment options often exhibit frequent utilization of the healthcare system. Ideally, we want this to be minimized to limit physician burnout.

The above description of the problem with chronic pain treatment is where the idea of multidisciplinary conferences (MDC) come in. Multidisciplinary care involves a team of providers working together to create and implement a new treatment plan for patients. Multidisciplinary care has been shown to be successful in oncology, inflammatory bowel disease, pediatrics, and cardiology. Chronic pain multidisciplinary teams often involve neurologists, anesthesiologists with specialty training in pain, physical medicine and rehabilitation specialists, physical or occupational therapists, functional neurosurgeons, spine surgeons, social workers, psychologists, nurses and midlevel providers. In this study, a MDC was formed that met monthly to discuss chronic pain patients and created individualized and holistic treatment plans for these patients. Patients were referred by their current pain specialists/provider after failure of treatment options.

In the next post, I will detail how data was collected for this study (what was measured in order to show improvement).