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Presentation Transcript
slide1

Hello.

This presentation has been prepared to run on PowerPoint 97.

To advance through the show click the left mouse button

anywhere inside the active screen. Your keyboard’s arrow keys are also enabled and offer the advantage of being able to go backwards as well as forwards.

Several additional slides have been included beyond those shown at the RACGP conference as these may contain information that is of use.

Please contact me for clarification or discussion of issues raised.

NB This presentation was prepared to be given as a lecture.

Simon Strauss

07 55313810

E-mail [email protected]

URL www.pain-education.com

Click your left mouse button on the next slide to begin

slide2

Do short courses on Pain Management provoke changes in General Practitioners’ pain patient management?

Presented bySimon Strauss adviserMedical Pain Education

slide3
One in three Australian households has one or more members with a pain complaint usually (80%) managed by a General Practitioner.

From: The Prevalence of Pain Complaints in a General Population: An Australian Study. Brisbane.1986. Fiona Guthrie , Fred Nicolosi and Simon Strauss

slide4
Little data seems to have been published on:

The actual management of pain patients in the General Practice setting

And whether or not

Educational intervention influences General Practitioners’ pain management

objectives
Objectives

1. To collect sentinel data on General Practitioners’ management of Initial Pain Consultations

2. Assess changes, if any, made following differing brief educational interventions.

overview mpe s practice assessment activities

Knowledge AcquisitionAssessed by formal written Examination

Maintenance of Changes

39 medical practitioners

followed at 4 months

Knowledge AcquisitionAssessed by formal written Examination

Overview MPE’s Practice Assessment Activities

Sentinel Data

58 medical practitioners

628 Initial Pain Consults

Post Acupuncture Seminar

44 medical practitioners

535 Initial Pain Consults

Post

Myofascial Seminar

34 medical practitioners

339 Initial Pain Consults

Postal (Pain Tools)

20 medical practitioners

247 Initial Pain Consults

overview extended for non lecture attendees
Overview -Extended for non-lecture attendees.

Knowledge acquisition and maintenance of provoked changes are not included in this presentation.

The postal group undertook an educational activity designed to increase usage of Pain Assessment Tools.

The postal group and the sentinel groups provide a useful view of what happens in the ‘wild’.

Many of the myofascial seminar attendees were extensively involved in chronic pain management prior to attending.

usage of pain assessment tools

This presentation details the

Usage of Pain Assessment Tools

Investigation Rates

Referral Rates

Script Generation Rates

In the context of o

Initial / Presenting Pain Consultations

usage of pain assessment tools sentinel group
Usage of Pain Assessment ToolsSentinel Group

% of Initial PainConsults

Data acquired prior to attending a Medical Pain Education acupuncture or myofascial pain management seminar

usage of pain assessment tools postal group
Usage of Pain Assessment ToolsPostal Group

Postal group received written educational material on the usage of VAS, McGill and Pain Diagrams

% of Initial PainConsults

usage of pain assessment tools pre post myofascial seminar 34 gps 339 audits
Usage of Pain Assessment ToolsPre - Post Myofascial Seminar34 GPs 339 Audits

% of Initial PainConsults

usage of pain assessment tools pre post acupuncture seminar 44 gps 535 audits
Usage of Pain Assessment ToolsPre - Post Acupuncture Seminar44 GPs 535 audits

% of Initial PainConsults

the following slides represent the worst case figures

The following slides represent the ‘worst case’ figures

That is, they reflect the number of initial pain consultations that resulted in the ordering of one or more investigations/scripts/referrals.

Therefore they cannot be used to give the actual numbers of x-rays ordered.

investigation rates
Investigation Rates

% of Initial PainConsults

investigation rate pre post myofascial seminar 34 gps 339 audits
Investigation RatePre - Post Myofascial Seminar34 GPs 339 Audits

% of Initial PainConsults

No clear trend

investigation rate pre post acupuncture seminar 44 medical practitioners 535 audits
Investigation Rate Pre-Post Acupuncture Seminar44 medical practitioners 535 Audits

% of Initial PainConsults

Pre-Post Investigations ratesX-rays -35%, CT -31%, MRI -50% and Serology -46%

referral rates
Referral rates

% of Initial PainConsults

referral rates pre post acupuncture seminar 44 medical practitioners 535 consults
Referral Rates Pre-Post Acupuncture Seminar44 medical practitioners 535 consults

% of Initial PainConsults

Physiotherapy referrals -52%, Physician -70%, Orthopaedic -44%, Neurosurgeon -66%, Rheumatologist -34%, Counselling -33%

script rates
Script Rates

% of Initial PainConsults

127 scripts per 100 Initial Pain Consultations

script rates pre post myofascial seminar 34 gps 339 audits
Script Rates Pre - Post Myofascial Seminar34 GPs 339 Audits

% of Initial PainConsults

Pre-Post Myofascial seminarAnalgesics +20%, NSAIs -16%, Steroids +18%, Antidepressants +220%

script rates pre post acupuncture seminar 44 medical practitioners 535 consults
Script Rates Pre - Post Acupuncture Seminar 44 medical practitioners 535 consults

% ofConsults

Pre-Post Acupuncture seminarAnalgesics -38%, NSAIs -24%, Steroids -44%, Antidepressants - 49%

conclusions
Conclusions

Comparison of sentinel and pre to post educational activity data reveals that General Practitioners’ pain patients’ management is modifiable by short educational interventions.

The extent of the changes provoked seems to be affected by the nature of the educational material presented.

The proposition that the provoked changes could lead to decreased health care costs has not been proven but seems to be attractive.

slide24

Medical Pain Education

31 Charlton Street.

Southport. Qld. 4215

Tel: 07 5531 3810, Fax: 07 5532 6199

URL: www.pain-education.com E-Mail: [email protected]

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