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Descriptive Analysis of an Interdisciplinary Musculoskeletal Program
Author(s) -
Santa Barbara Matthew T.,
Cortazzo Megan,
Emerick Trent,
Furnier Jessica,
Duff Jesse,
Shapiro Steve,
Zigler Christine K.,
Badway Andrea,
Sowa Gwendolyn
Publication year - 2020
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1002/pmrj.12288
Subject(s) - medicine , physical therapy , retrospective cohort study , magnetic resonance imaging , medical prescription , cohort , manual therapy , oswestry disability index , neck pain , veterans affairs , low back pain , radiology , alternative medicine , nursing , pathology
Background Interdisciplinary musculoskeletal programs address comorbidities confounding musculoskeletal conditions and serve as an alternative to the single provider model. Objective Descriptive analysis of an interdisciplinary musculoskeletal program. Design Retrospective descriptive analysis of patients enrolled in an interdisciplinary musculoskeletal program. Retrospective subanalysis: cohort of patients enrolled in interdisciplinary program with low back pain compared to historical cohort of patients in a single provider clinic. Setting Academic interdisciplinary musculoskeletal health program. Patients Patients referred to program with at least one follow‐up visit over a 2‐year period. Interventions Interdisciplinary musculoskeletal program involving physiatry, pain anesthesia, nutrition, psychology, rheumatology, sleep medicine, nursing, and physical therapy. Main Outcome Measurements Patient Specific Functional Scale (PSFS), Oswestry Low Back Disability Index (ODI), number of magnetic resonance imaging (MRI) scans, computed tomography (CT) scans, opioid prescriptions; Press Ganey scores. Results One hundred and seventy‐three patients were enrolled and had at least one follow‐up visit. Twenty‐four percent of patients with any musculoskeletal complaint demonstrated clinically significant improvements in total PSFS. Mean improvement in PSFS was + 0.864 (SD 1.94), which was a statistically significant improvement ( P = .0005), but not clinically significant. Magnetic resonance imaging was ordered for 5% of patients, and no computed tomography scans were ordered. Six percent of patients received opioid prescriptions. Press Ganey scores: 96% responded favorably in regard to physician communication quality, 86% of patients responded favorably for access to care, and 78% responded favorably for care coordination. 27.8% of patients with low back pain in the interdisciplinary program achieved a significant decrease in their ODI, compared to 26.6% in the single provider clinic ( P = .87). Conclusions Interdisciplinary musculoskeletal programs are a promising model to improve the functioning of patients with musculoskeletal pain and decrease downstream utilization. These programs may be more appropriate for patients at higher risk of developing chronic pain.