Evidence map›Paper›PMID 37005610›Full record

ArticleBMC health services research2023

Telehealth for management of chronic non-cancer pain and opioid use disorder in safety net primary care.

Alexis Cooke, Stacy Castellanos, Celeste Enriquez, Pamela Olsen, Christine Miaskowski, Margot Kushel, Kelly Ray Knight

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Alexis CookeDepartment of Community Health Systems, School of Nursing, University of California - San Francisco, 2 Koret Way, N505, San Francisco, CA, 94143-0608, USA.
Stacy CastellanosDepartment of Humanities and Social Sciences, School of Medicine, University of California - San Francisco, 490 Illinois Street, 7th Floor, San Francisco, CA, 94143-0850, USA.
Celeste EnriquezCenter for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, University of California - San Francisco, UCSF Box 1339, San Francisco, CA, 94143-0608, USA.
Pamela OlsenCenter for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, University of California - San Francisco, UCSF Box 1339, San Francisco, CA, 94143-0608, USA.
Christine MiaskowskiDepartment of Physiological Nursing, School of Nursing, University of California - San Francisco, 2 Koret Way, Rm 631, San Francisco, CA, 94143-0608, USA.
Margot KushelCenter for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, University of California - San Francisco, UCSF Box 1339, San Francisco, CA, 94143-0608, USA.
Kelly Ray KnightDepartment of Humanities and Social Sciences, School of Medicine, University of California - San Francisco, 490 Illinois Street, 7th Floor, San Francisco, CA, 94143-0850, USA. kelly.knight@ucsf.edu.ORCID http://orcid.org/0000-0002-5838-8592
University of California, San Francisco · USSan Francisco General Hospital · US

Funding

Scientific and Technical CoreP2CHD041022 · NICHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Martha Jane Bailey · 2016 to 2026
$6.9M
CALIFORNIA CENTER FOR POPULATION TRAINING PROGRAMT32HD007545 · NICHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI HIRAM BELTRAN-SANCHEZ, Megan M Sweeney · 2001 to 2026
$4.1M
Examining the Consequences of Reductions in Opioid Prescribing on Patients, Clinical Care, and Community HealthR01DA043631 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KNIGHT, KELLY RAY · 2017 to 2021
$2.7M
NICHD NIH HHS P2C HD041022NICHD NIH HHS T32 HD007545NIDA NIH HHS R01 DA043631
6 · The paper itself

Abstract

backgroundThe SARS-CoV-2 (COVID-19) pandemic increased use of telehealth for the management of opioid use disorder and chronic non-cancer pain in primary care safety net clinical systems. Significant barriers to telehealth exist, little is known about how these barriers impact urban safety net, primary care providers and their patients. The objective of this study was to qualitatively assess the benefits and challenges of telehealth for management of chronic non-cancer pain, opioid use disorder, and multi-morbidity in primary care, safety net clinical systems.

methodsWe interviewed patients with chronic non-cancer pain and history of substance use (n = 22) and their primary care clinicians (n = 7) in the San Francisco Bay Area, March-July 2020. We recorded, transcribed, coded, and content analyzed interviews.

resultsCOVID-19 shelter-in-place orders contributed to increases in substance use and uncontrolled pain, and posed challenges for monitoring opioid safety and misuse through telehealth. None of the clinics used video visits due to low digital literacy/access. Benefits of telehealth included decreased patient burden and missed appointments and increased convenience and control of some chronic conditions (e.g., diabetes, hypertension). Telehealth challenges included loss of contact, greater miscommunication, and less comprehensive care interactions.

conclusionsThis study is one of the first to examine telehealth use in urban safety net primary care patients with co-occurring chronic non-cancer pain and substance use. Decisions to continue or expand telehealth should consider patient burden, communication and technology challenges, pain control, opioid misuse, and medical complexity.

Indexed as

Chronic PainCOVID-19Opioid-Related DisordersTelemedicineAnalgesics, OpioidHumansPrimary Health CareSARS-CoV-2Analgesics, OpioidChronic non-cancer painOpioidsPain managementPrimary careQualitativeTelehealthTelemedicine

Identifiers

PMID37005610
PMCPMC10067010
OpenAlexW4362521847

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.