ArticleFederal practitioner : for the health care professionals of the VA, DoD, and PHS2025
E-Consults Bridge to Interdisciplinary Team Care for Rural Appalachian Veterans With Chronic Pain and Opioid Use Disorder.
Article in Federal practitioner : for the health care professionals of the VA, DoD, and PHS, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
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Abstract
Background: Co-occurring chronic pain and opioid use disorder (OUD) is often managed by primary care practitioners (PCPs) for rural veterans. Interdisciplinary teams (IDTs) and e-consults have shown promise at the US Department of Veterans Affairs for supporting PCPs. This quality improvement study sought to examine the impact of an e-consult service on pain care trajectories, determine the feasibility and reach of the RESTORE IDT appointment program, and determine the impact of RESTORE on engagement in evidence-based care. Observations: A retrospective chart review was conducted at the Salem Veterans Affairs Healthcare System that primarily serves rural veterans in Central Appalachia. Veterans at risk for OUD with co-occurring chronic pain whose PCP placed an e-consult during a 1-year period were included. The following data were extracted from the electronic health record: demographics, referrals, treatment plans, and treatment engagement. Results were summarized using descriptive statistics. Of the 77 e-consults placed in 1 year, 75% were placed by PCPs, and 83% were requests for recommendations on medication adjustments. The reviewing pharmacist referred 19 veterans to RESTORE; of those, 17 (89%) agreed to be referred to a pain IDT specializing in nonpharmacologic pain management and 13 (68%) agreed to initiate buprenorphine. Conclusions: This study demonstrated preliminary support for the feasibility of e-consults to increase engagement in evidence-based treatments. Additional research is needed.
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