PMID- 35239110 OWN - NLM STAT- MEDLINE DCOM- 20220511 LR - 20230502 IS - 1525-1497 (Electronic) IS - 0884-8734 (Print) IS - 0884-8734 (Linking) VI - 37 IP - 6 DP - 2022 May TI - Teaming in Interdisciplinary Chronic Pain Management Interventions in Primary Care: a Systematic Review of Randomized Controlled Trials. PG - 1501-1512 LID - 10.1007/s11606-021-07255-w [doi] AB - BACKGROUND: Current pain management recommendations emphasize leveraging interdisciplinary teams. We aimed to identify key features of interdisciplinary team structures and processes associated with improved pain outcomes for patients experiencing chronic pain in primary care settings. METHODS: We searched PubMed, EMBASE, and CINAHL for randomized studies published after 2009. Included studies had to report patient-reported pain outcomes (e.g., BPI total pain, GCPS pain intensity, RMDQ pain-related disability), include primary care as an intervention setting, and demonstrate some evidence of teamwork or teaming; specifically, they needed to involve at least two clinicians interacting with each other and with patients in an ongoing process over at least two timepoints. We assessed study quality with the Cochrane Risk of Bias tool. We narratively synthesized intervention team structures and processes, comparing among interventions that reported a clinically meaningful improvement in patient-reported pain outcomes defined by the minimal clinically important difference (MCID). RESULTS: We included 13 total interventions in our review, of which eight reported a clinically meaningful improvement in at least one patient-reported pain outcome. No included studies had an overall high risk of bias. We identified the role of a care manager as a common structural feature of the interventions with some clinical effect on patient-reported pain. The team processes involving clinicians varied across interventions reporting clinically improved pain outcomes. However, when analyzing team processes involving patients, six of the interventions with some clinical effect on pain relied on pre-scheduled phone calls for continuous patient follow-up. DISCUSSION: Our review suggests that interdisciplinary interventions incorporating teamwork and teaming can improve patient-reported pain outcomes in comparison to usual care. Given the current evidence, future interventions might prioritize care managers and mechanisms for patient follow-up to help bridge the gap between clinical guidelines and the implementation of interdisciplinary, team-based chronic pain care. CI - (c) 2022. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply. FAU - Connell, Natalie B AU - Connell NB AD - Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, 795 Willow Road (152 MPD), Menlo Park, CA, 94025, USA. AD - Emory School of Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA. FAU - Prathivadi, Pallavi AU - Prathivadi P AD - Department of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA. AD - Department of General Practice, Monash University, Melbourne, Australia. FAU - Lorenz, Karl A AU - Lorenz KA AD - Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, 795 Willow Road (152 MPD), Menlo Park, CA, 94025, USA. AD - Department of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA. FAU - Zupanc, Sophia N AU - Zupanc SN AD - Department of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA. AD - Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA. FAU - Singer, Sara J AU - Singer SJ AD - Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, 795 Willow Road (152 MPD), Menlo Park, CA, 94025, USA. AD - Department of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA. FAU - Krebs, Erin E AU - Krebs EE AD - Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA. AD - Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA. FAU - Yano, Elizabeth M AU - Yano EM AD - Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater LA Healthcare System, Los Angeles, CA, USA. AD - Fielding School of Public Health, Department of Health Policy and Management, University of California Los Angeles, Los Angeles, CA, USA. AD - Geffen School of Medicine, Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA. FAU - Wong, Hong-Nei AU - Wong HN AD - Lane Medical Library, Stanford University School of Medicine, Palo Alto, CA, USA. FAU - Giannitrapani, Karleen F AU - Giannitrapani KF AUID- ORCID: 0000-0003-0987-6204 AD - Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, 795 Willow Road (152 MPD), Menlo Park, CA, 94025, USA. Karleen@stanford.edu. AD - Department of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA. Karleen@stanford.edu. LA - eng GR - IK2 HX003077/HX/HSRD VA/United States GR - 19-075/health services research and development/ GR - RCS 05-195/health services research and development/ PT - Research Support, U.S. Gov't, Non-P.H.S. PT - Systematic Review DEP - 20220303 PL - United States TA - J Gen Intern Med JT - Journal of general internal medicine JID - 8605834 SB - IM MH - Bias MH - *Chronic Pain/therapy MH - Humans MH - *Pain Management MH - Primary Health Care MH - Randomized Controlled Trials as Topic PMC - PMC9086072 OTO - NOTNLM OT - Chronic pain OT - Interdisciplinary team OT - Primary care OT - Systematic review COIS- The authors declare that they do not have a conflict of interest. EDAT- 2022/03/04 06:00 MHDA- 2022/05/12 06:00 PMCR- 2023/05/01 CRDT- 2022/03/03 12:19 PHST- 2021/06/17 00:00 [received] PHST- 2021/10/28 00:00 [accepted] PHST- 2022/03/04 06:00 [pubmed] PHST- 2022/05/12 06:00 [medline] PHST- 2022/03/03 12:19 [entrez] PHST- 2023/05/01 00:00 [pmc-release] AID - 10.1007/s11606-021-07255-w [pii] AID - 7255 [pii] AID - 10.1007/s11606-021-07255-w [doi] PST - ppublish SO - J Gen Intern Med. 2022 May;37(6):1501-1512. doi: 10.1007/s11606-021-07255-w. Epub 2022 Mar 3.