Orlando J, Semple T, Edwards S, Dow M
CALHN Pain Management Unit, The Queen Elizabeth Hospital, Adelaide SA, Australia
Background: Consumers living in regional South Australia have traditionally travelled to Adelaide to access tertiary-level pain management services. SA Health recently invested in the delivery of multidisciplinary outreach pain services as part of a state-wide model of care to address the inequities in access.
Process: The CALHN Pain Management Unit commenced a two-day, monthly multidisciplinary outreach service at Whyalla Hospital in May 2018. Telehealth is utilised to augment care between site visits. Pain questionnaires as part of the electronic Persistent Pain Outcome Collaboration (ePPOC) are recorded at referral and at end of episode, as well as health literacy and patient engagement scores.
Analysis: Over 18 months, 125 patients received input through the outreach service. There were 325 occasions of service. Pain questionnaires at end of episode were completed by 62 patients and illustrated improvements in psychosocial measures, such as DASS-21 depression and pain self-efficacy. Health literacy scoring was marginal/limited (53%) and engagement was low (46%). Staff travel costs to Whyalla totalled $42,000; avoided patient travel reimbursements to Adelaide totalled $54,000.
Outcomes: The CALHN Pain Management Unit improved access to pain management services in regional South Australia whilst simultaneously reduced the economic burden of providing this service. Two additional outreach sites have since been established in Port Pirie and Port Lincoln. The challenges in this patient population include high levels of pain interference; high levels of psychosocial distress; and low levels of consumer health literacy and engagement. Providing pain management into regional areas remains an area for continued service improvement.
Joseph Orlando is a Senior Physiotherapist in the CALHN and works across the Pain Management Unit, Spinal Assessment Clinics and the Emergency Department of the Royal Adelaide Hospital. He has undertaken postgraduate qualifications in musculoskeletal physiotherapy and has published research on topics related to telehealth and low back pain.