title: Preliminary outcomes of a pilot physical therapy program for HIV-infected patients with chronic pain.
abstract: Chronic pain in HIV-infected individuals is common and often undertreated. Physical therapy (PT) is an evidence-based nonpharmacologic treatment for chronic pain. Our objective is to present the results of a pilot PT program in an HIV pain/palliative care clinic, which is embedded within a Ryan White-funded multidisciplinary HIV primary care clinic. Medical records of HIV-infected patients participating in a PT program between November 2012 and July 2013 were retrospectively reviewed. Pain scores on a 0-10 scale and cost data were collected and analyzed. Among 43 patients referred, 27 collectively attended 86 sessions. Median age of enrolled patients was 54 (IQR 49-58). Sixteen (59%) were African-American and 20 (77%) had an undetectable HIV viral load. Mean pain score at initial visit was 6.5 (SD = 1.1). The average session-level decrease was 2.6 (SD = 1.7) and patient-level decrease was 2.5 (SD = 1.2). The largest payors were Medicare managed care (28%), Medicaid (21%), and Ryan White grant-related funds (18%). When the first four months of the program are excluded to account for slow start-up, the program's monthly net revenue during the remaining five months was $163. We present preliminary data from a low-cost pilot PT program integrated into an HIV clinic in a primary care setting associated with clinically significant improvements in pain. Further investigation into the implementation of such programs is essential.
authors: a Department of Medicine , University of Alabama at Birmingham , Birmingham , AL , USA.
authors: Okechukwu
authors: O
authors: Mgbemena
authors: Andrew O
authors: AO
authors: Westfall
authors: Christine S
authors: CS
authors: Ritchie
authors: Jennifer
authors: J
authors: Hicks
authors: James L
authors: JL
authors: Raper
authors: Edgar Turner
authors: ET
authors: Overton
authors: Wynne E
authors: WE
authors: Norton
authors: Jessica S
authors: JS
authors: Merlin
mesh_terms: D059350:Chronic Pain / Q000191:economics / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D059408:Pain Management / Q000379:methods; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D015995:Prevalence; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: HIV; Ryan White program; chronic pain; nonpharmacologic treatment; physical therapy