Abstract
Purpose: The objective of this survey was to examine the services offered by multidisciplinary pain treatment facilities (MPTFs) across Canada and to compare access to care at these MPTFs.
Methods: A MPTF was defined as a clinic that advertised specialized multidisciplinary services for the diagnosis and management of patients with chronic pain, having a minimum of three different health care disciplines (including at least one medical speciality) available and integrated within the facility. The search method included approaching all hospital and rehabilitation centre administrators in Canada, the Insurance Bureau of Canada, the Workplace Safety and Insurance Board or similar body in each province. Designated investigators were responsible for confirming and supplementing MPTFs from the preliminary list for each province. Administrative leads at each eligible MPTF were asked to complete a detailed questionnaire regarding their MPTF infrastructure, clinical, research, teaching and administrative activities.
Results: Completed survey forms were received from 102 MPTFs (response rate 85%) with 80% concentrated in major cities, and none in Prince Edward Island and the Territories. The MPTFs offer a wide variety of treatments including non-pharmacological modalities such as interventional, physical and psychological therapy. The median wait time for a first appointment in public MPTFs is six months, which is approximately 12 times longer than non-public MPTFs. Eighteen pain fellowship programs exist in Canadian MPTFs and 64% engage in some form of research activities
Conclusion: Canadian MPTFs are unable to meet clinical demands of patients suffering from chronic pain, both in terms of regional accessibility and reasonable wait time for patients’ first appointment.
Résumé
Objectif: L’objectif de ce sondage était d’examiner les services offerts par les établissements pluridisciplinaires de traitement de la douleur (MPTF — multidisciplinary pain treatment facility) au Canada et de comparer l’accès aux soins dans ces MPTF.
Méthode: Un MPTF a été défini comme une clinique affichant des services pluridisciplinaires spécialisés pour le diagnostic et la prise en charge des patients souffrant de douleurs chroniques, et possédant au moins trois disciplines différentes de soins de santé (y compris au moins une spécialité médicale) à disposition et intégrées dans l’établissement. La méthode de recherche comprenait la prise de contact avec tous les administrateurs d’hôpitaux et de centres de réhabilitation canadiens, le Bureau d’assurance du Canada, la Commission de la sécurité professionnelle et de l’assurance contre les accidents du travail ou avec d’autres organismes similaires dans chaque province. Des chercheurs désignés étaient responsables pour la confirmation et l’ajout de MPTF à la liste préliminaire dans chaque province. On a demandé à la direction administrative de chaque MPTF éligible de remplir un questionnaire détaillé concernant l’infrastructure de son MPTF ainsi que ses activités de soins, de recherche, d’enseignement et de gestion.
Résultats: Des formulaires de sondage complétés ont été reçus de 102 MPTF (taux de réponse de 85 %), dont 80 % sont situés dans des grandes villes, et aucun sur l’Ile du Prince Edouard et les Territoires. Les MPTF offrent une grande diversité de traitements, y compris des modalités non pharmacologiques, comme par exemple les traitements interventionnels, physiques et psychologiques. Le temps d’attente médian pour un premier rendez-vous dans un MPTF public est de six mois, ce qui est environ 12 fois plus long que dans un MPTF non public. Dix-huit programmes de fellowship en douleur existent dans les MPTF canadiens, et 64 % de ces établissements ont des activités de recherche.
Conclusion: Les établissements pluridisciplinaires de traitement de la douleur canadiens ne peuvent répondre aux demandes cliniques de patients souffrant de douleurs chroniques, que ce soit en termes d’accessibilité régionale ou de temps d’attente raisonnable pour le premier rendez-vous d’un patient.
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Funding: The study was funded by the Canadian Institutes of Health Research (via the CIHR/Rx&D Collaborative Research Program) in partnership with Pfizer Canada and the three networks of the Fonds de la recherche en santé du Québec (Santé buccodentaire, Adaption-réadaption, Neurosciences et santé mentale).
Competing interest: None declared.
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Peng, P., Choiniere, M., Dion, D. et al. Challenges in accessing multidisciplinary pain treatment facilities in Canada. Can J Anesth 54, 977–984 (2007). https://doi.org/10.1007/BF03016631
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DOI: https://doi.org/10.1007/BF03016631