在 HIV 诊所的医疗保健团队中增加物理治疗师可增加物理治疗转诊并减少为 HIV 感染者的慢性肌肉骨骼疼痛提供的阿片类药物处方,Open Forum Infectious Diseases

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在 HIV 诊所的医疗保健团队中增加物理治疗师可增加物理治疗转诊并减少为 HIV 感染者的慢性肌肉骨骼疼痛提供的阿片类药物处方
Open Forum Infectious Diseases ( IF 4.2 ) Pub Date : 2021-02-05 , DOI: 10.1093/ofid/ofab047
Vinoja Sebanayagam ₁ , Nichole Chakur ₂ , Nana Ama Baffoe ₁ , Brian Reed ₁ , Jarrett Weinberger ₁ , Brandon S Twardy ₁ , Jennifer Veltman ₁

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背景肌肉骨骼 (MSK) 疼痛在 HIV 感染者 (PLWH) 中很常见。医疗保健提供者有时会开阿片类药物来控制疼痛，这可能导致阿片类药物滥用。包括物理治疗在内的跨学科方法已成功地在各种医疗保健环境中管理 MSK 疼痛。因此，我们试图找出招募物理治疗师 (PT) 对医生在管理 PLWH MSK 疼痛的培训中所开的阿片类药物处方和物理治疗转诊数量的影响。方法我们对内科医师在底特律一家 HIV 诊所接受培训之前（2017 年）和之后（2018 年）为医疗团队招募 PT 进行了回顾性图表审查，并收集了人口统计学和临床数据。我们还对学员进行了调查，以评估 PT 的添加如何影响他们的学习。获得了机构审查委员会的豁免。结果结果显示，在 2017 年和 2018 年的数据集中，在诊所看到的所有 PLWH 中，分别有 28/249 (11%) 和 37/178 (21%) 患有慢性 MSK 疼痛。2017 年，所有 28 名 MSK 疼痛患者均使用了阿片类药物。增加 PT 后，这一数字在 2018 年有所下降（10/37 名患者；P < .0001）。加入 PT 后，物理治疗转诊人数显着增加（2017 年：5/28 名患者；2018 年：17/37 名患者；P = .03）。学员们认为 PT 有助于提高他们的检查技能并为患者制定治疗计划。结

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Adding a Physical Therapist to the Health Care Team in an HIV Clinic Increases Physical Therapy Referrals and Reduces Opioid Prescriptions Provided for Chronic Musculoskeletal Pain in Patients Living With HIV

Background Musculoskeletal (MSK) pain is common in people living with HIV (PLWH). Health care providers sometimes prescribe opioids to control pain, which may lead to opioid misuse. An interdisciplinary approach that includes physical therapy has been successful in managing MSK pain in various health care settings. Therefore, we sought to find the impact of recruiting a physical therapist (PT) on the number of opioid prescriptions and physical therapy referrals made by physicians in training to manage MSK pain in PLWH. Methods We performed a retrospective chart review of patients seen by Internal Medicine physicians in training in an HIV clinic in Detroit before (2017) and after (2018) recruiting a PT to the health care team and collected demographic and clinical data. We also surveyed the trainees to assess how the PT addition influenced their learning. Institutional review board waiver was obtained. Results Results showed that of all PLWH seen at the clinic, 28/249 (11%) and 37/178 (21%) had chronic MSK pain in the 2017 and 2018 data sets, respectively. In 2017, all 28 patients with MSK pain were prescribed opioids. This decreased in 2018 after the PT addition (10/37 patients; P < .0001). The number of physical therapy referrals significantly increased after the PT addition (2017: 5/28 patients; 2018: 17/37 patients; P = .03). Trainees felt that the PT helped improve their examination skills and develop a treatment plan for patients. Conclusions The addition of a PT encouraged physicians in training to utilize nonopioid management of MSK pain in PLWH and enhanced their learning experience, as perceived by the trainees.

更新日期：2021-02-05

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