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Research ArticleOriginal Research

Provision of Recommended Chronic Pain Assessment and Management in Primary Care: Does Patient-Centered Medical Home (PCMH) Recognition Make a Difference?

Nancy Elder, Michelle Penm, Harini Pallerla, Mary Beth Vonder Meulen, Amy Diane Short, Tiffiny Diers, Ryan Joseph Imhoff, Brendan Wilson and Jill Martin Boone
The Journal of the American Board of Family Medicine July 2016, 29 (4) 474-481; DOI: https://doi.org/10.3122/jabfm.2016.04.160037
Nancy Elder
From the Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH (NE, HP, MBVM, RJI); the University of Cincinnati, Cincinnati, OH (MP, BW); the Center for Improvement Science (ADS); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH (TD); University of Cincinnati Center James L. Winkle College of Pharmacy, Cincinnati, OH (JMB).
MD, MSPH
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Michelle Penm
From the Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH (NE, HP, MBVM, RJI); the University of Cincinnati, Cincinnati, OH (MP, BW); the Center for Improvement Science (ADS); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH (TD); University of Cincinnati Center James L. Winkle College of Pharmacy, Cincinnati, OH (JMB).
B. Pharm (Hons), MBBS, MMed (Pain Management)
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Harini Pallerla
From the Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH (NE, HP, MBVM, RJI); the University of Cincinnati, Cincinnati, OH (MP, BW); the Center for Improvement Science (ADS); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH (TD); University of Cincinnati Center James L. Winkle College of Pharmacy, Cincinnati, OH (JMB).
MS
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Mary Beth Vonder Meulen
From the Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH (NE, HP, MBVM, RJI); the University of Cincinnati, Cincinnati, OH (MP, BW); the Center for Improvement Science (ADS); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH (TD); University of Cincinnati Center James L. Winkle College of Pharmacy, Cincinnati, OH (JMB).
RN
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Amy Diane Short
From the Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH (NE, HP, MBVM, RJI); the University of Cincinnati, Cincinnati, OH (MP, BW); the Center for Improvement Science (ADS); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH (TD); University of Cincinnati Center James L. Winkle College of Pharmacy, Cincinnati, OH (JMB).
MHSA
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Tiffiny Diers
From the Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH (NE, HP, MBVM, RJI); the University of Cincinnati, Cincinnati, OH (MP, BW); the Center for Improvement Science (ADS); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH (TD); University of Cincinnati Center James L. Winkle College of Pharmacy, Cincinnati, OH (JMB).
MD
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Ryan Joseph Imhoff
From the Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH (NE, HP, MBVM, RJI); the University of Cincinnati, Cincinnati, OH (MP, BW); the Center for Improvement Science (ADS); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH (TD); University of Cincinnati Center James L. Winkle College of Pharmacy, Cincinnati, OH (JMB).
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Brendan Wilson
From the Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH (NE, HP, MBVM, RJI); the University of Cincinnati, Cincinnati, OH (MP, BW); the Center for Improvement Science (ADS); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH (TD); University of Cincinnati Center James L. Winkle College of Pharmacy, Cincinnati, OH (JMB).
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Jill Martin Boone
From the Department of Family and Community Medicine, University of Cincinnati, Cincinnati, OH (NE, HP, MBVM, RJI); the University of Cincinnati, Cincinnati, OH (MP, BW); the Center for Improvement Science (ADS); Department of Internal Medicine, University of Cincinnati, Cincinnati, OH (TD); University of Cincinnati Center James L. Winkle College of Pharmacy, Cincinnati, OH (JMB).
PharmD
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    Figure 1.

    The provision of recommended chronic pain assessment and management by patient-centered medical home status (PCMH).

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    Figure 2.

    The provision of recommended chronic opioid assessment and management by patient-centered medical home status (PCMH).

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    Table 1.

    Provider Demographics (Self-reported by Practices)

    DemographicsPrior PCMHOngoing PCMHNo PCMH
    Providers, n311816
    Currently a resident*58.100
    Family medicine physician9.735.325
    Internal medicine physician77.411.868.8
    Internal medicine/pediatric physician12.929.46.3
    Nurse practitioner/physician assistant023.50
    Mean age (years)*344537
    Female sex336750
    Race/ethnicity
        White66.768.887.5
        African American6.718.86.3
        Asian American26.712.56.3
        Hispanic6.506.7
    • Data are percentages unless otherwise indicated.

    • ↵* Statistically significant between the 3 cohorts (P < .001).

    • PCMH, patient-centered medical home.

    • View popup
    Table 2.

    Patient Demographics from Chart Review of Patients with Chronic Pain

    Prior PCMHOngoing PCMHNo PCMH
    Patients, n128242115
    Mean age (years)*525659
    Female sex*50.470.255.7
    Race/ethnicity*
        White705088
        African American304810
        Asian American/other022
        Hispanic112
    • Data are percentages unless otherwise indicated.

    • ↵* Statistically significant between the cohorts (P < .001).

    • PCMH, patient-centered medical home.

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The Journal of the American Board of Family     Medicine: 29 (4)
The Journal of the American Board of Family Medicine
Vol. 29, Issue 4
July-August 2016
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Provision of Recommended Chronic Pain Assessment and Management in Primary Care: Does Patient-Centered Medical Home (PCMH) Recognition Make a Difference?
Nancy Elder, Michelle Penm, Harini Pallerla, Mary Beth Vonder Meulen, Amy Diane Short, Tiffiny Diers, Ryan Joseph Imhoff, Brendan Wilson, Jill Martin Boone
The Journal of the American Board of Family Medicine Jul 2016, 29 (4) 474-481; DOI: 10.3122/jabfm.2016.04.160037

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Provision of Recommended Chronic Pain Assessment and Management in Primary Care: Does Patient-Centered Medical Home (PCMH) Recognition Make a Difference?
Nancy Elder, Michelle Penm, Harini Pallerla, Mary Beth Vonder Meulen, Amy Diane Short, Tiffiny Diers, Ryan Joseph Imhoff, Brendan Wilson, Jill Martin Boone
The Journal of the American Board of Family Medicine Jul 2016, 29 (4) 474-481; DOI: 10.3122/jabfm.2016.04.160037
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Keywords

  • Opioid Analgesics
  • Arthralgia
  • Chronic Disease
  • Chronic Pain
  • Documentation
  • Empathy
  • Humans
  • Internship and Residency
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