Maintaining Access to an Interdisciplinary Pain Program During COVID-19

Meltzer, Karen; Zafereo, Jason; Noe, Carl; Jarrett, Robin

Research Objectives 1. To compare patient attendance in an interdisciplinary pain program (IPP) before and during the COVID-19 pandemic. 2. To describe programmatic changes in response to patient needs during the pandemic. Design Cohort comparison of IPP attendance rates before versus during the pandemic. Setting Outpatient IPP (consisting of physical therapy [PT], cognitive behavioral therapy [CBT], and medication management [MM]) within an academic medical center. Participants Adults diagnosed with chronic pain (N=259) who attended ≥ 1 IPP session between March 2017 and February 2020. Interventions Before COVID-19, PT, CBT, and MM delivered in-person. During COVID-19, PT and MM delivered remotely and in person; CBT delivered via telehealth to individuals and groups to allow social distance and respond to facial affect. Main Outcome Measures Objective 1. Patient attendance = attending ≥ 6 days of PT or CBT (individual and/or group). Results Objective 1. Before COVID-19, IPP attendance (from 3/20/2017 to 3/4/2020) was 76%. Since COVID-19 and through 2/2021, attendance was 65%. Objective 2: During COVID-19, PT included both telehealth and masked, in-person sessions. CBT was delivered through telehealth. IPP psychologist's role grew to promote evidence-based nonpharmacologic intervention for COVID-19 and reduce vaccination hesitation. Conclusions Overall, IPP clinicians and staff maintained safe access to interdisciplinary care for adults with chronic pain. Despite the global pandemic 65% of the patients completed the IPP. The 11% reduction in attendance may reflect increased biopsychosocial burdens experienced by patients with chronic pain during COVID-19. As chronic pain affects more Americans than diabetes, heart disease, and cancer combined, future studies are needed to identify the barriers to attendance among patients before and after COVID-19. Determining how to best reduce the risk of attrition will assist patients in benefiting fully from IPP treatment. Author(s) Disclosures None related to this project.