title: Multidisciplinary chronic pain management in a rural Canadian setting.
abstract: BACKGROUND
  Chronic pain is prevalent, complex and most effectively treated by a multidisciplinary team, particularly if psychosocial issues are dominant. The limited access to and high costs of such services are often prohibitive for the rural patient. We describe the development and 18-month outcomes of a small multidisciplinary chronic pain management program run out of a physician's office in rural Alberta.
  
  
  METHODS
  The multidisciplinary team consisted of a family physician, physiatrist, psychologist, physical therapist, kinesiologist, nurse and dietician. The allied health professionals were involved on a part-time basis. The team triaged referral information and patients underwent either a spine or medical care assessment. Based on the findings of the assessment, the team managed the care of patients using 1 of 4 methods: consultation only, interventional spine care, supervised medication management or full multidisciplinary management. We prospectively and serially recorded self-reported measures of pain and disability for the supervised medication management and full multidisciplinary components of the program.
  
  
  RESULTS
  Patients achieved clinically and statistically significant improvements in pain and disability.
  
  
  CONCLUSIONS
  Successful multidisciplinary chronic pain management services can be provided in a rural setting.
authors.affiliation: Central Alberta Pain and Rehabilitation Institute, Alberta Health Services, Lacombe, Altanta, USA. rburnham@telusplanet.net
authors.forename: Robert
authors.initials: R
authors.lastname: Burnham
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Day
authors.forename: Wallace
authors.initials: W
authors.lastname: Dudley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta; D000704:Analysis of Variance; D002908:Chronic Disease; D004046:Dietetics / Q000458:organization & administration; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006801:Humans; D018953:Kinesiology, Applied / Q000458:organization & administration; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration; D009818:Office Nursing / Q000458:organization & administration; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology; D010147:Pain Measurement; D010348:Patient Care Team / Q000458:organization & administration*; D017060:Patient Satisfaction; D026761:Physical Therapy Specialty / Q000458:organization & administration; D010810:Physical and Rehabilitation Medicine / Q000458:organization & administration; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D011586:Psychology, Clinical / Q000458:organization & administration; D012017:Referral and Consultation / Q000458:organization & administration; D019035:Rural Health Services / Q000458:organization & administration*