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Development and Pilot Test of a New Set of Good Practice Indicators for Chronic Nonmalignant Pain Management.
Saturno, Pedro Jesus; Ángel-García, Daniel; Martínez-Nicolás, Ismael; López Soriano, Francisco; Escolar Reina, Maria Pilar; Guerrero Díaz, María Beatriz; Ros Martínez, María Encarnación; Medina Mirapeix, Francesc; Saturno Marcos, Mayo.
Afiliação
  • Saturno PJ; Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
  • Ángel-García D; San Antonio Catholic University of Murcia, Department of Physiotherapy, Murcia, Spain.
  • Martínez-Nicolás I; San Antonio Catholic University of Murcia, Department of Physiotherapy, Murcia, Spain.
  • López Soriano F; Department of Physiotherapy, San Antonio Catholic University of Murcia, Murcia, Spain.
  • Escolar Reina MP; Department of Physical Therapy, Regional Campus of International Excellence "Campus Mare Nostrum, University of Murcia, Murcia, Spain.
  • Guerrero Díaz MB; Cartagena-East Health Center, Cartagena, Colombia.
  • Ros Martínez ME; Multidisciplinary Educational Unit on Family and Community Care, Cartagena-Mar Menor, Murcia.
  • Medina Mirapeix F; Department of Physical Therapy, Regional Campus of International Excellence "Campus Mare Nostrum, University of Murcia, Murcia, Spain.
  • Saturno Marcos M; Department of Anesthesiology and Reanimation, Reina Sofía University Hospital, Murcia, Spain.
Pain Pract ; 19(1): 37-51, 2019 01.
Article em En | MEDLINE | ID: mdl-29885032
OBJECTIVES: This study was designed to address the current relative void of valid measures by developing evidence-based quality indicators for pain management of chronic nonmalignant pain. METHODS: We performed a 10-year literature search to identify guidelines and review articles on chronic pain management to identify evidence-based recommendations for the different conditions associated to chronic pain. A complementary search of indicators and indicator-related articles was also performed. Then, we built new indicators or adapted existing ones to cover all the evidence-based recommendations we found. The resulting set was pilot tested for feasibility, reliability (kappa), and usefulness to identify quality problems, using the Lot Quality Acceptance method (α ≤ 0.05 and ß ≤ 0.01) for 75% (40% threshold) and 95% (70% threshold) compliance standards, and estimates with binomial exact 95% confidence intervals. We reviewed clinical records from a primary care center, a medium-size hospital (250 beds), and a large hospital (500 beds). RESULTS: Forty-six indicators were developed (6 general and 40 condition specific). Thirty-three were feasible in primary care and/or hospitals. Feasible indicators were also reliable (most kappa > 0.7). Regarding compliance, 4 quality indicators obtained compliance levels over 60%, addressing pharmacological treatment, multimodal approach, and appropriate use of neuro-image tests, while 16 obtained compliance scores under 15% (6 with 0% compliance). CONCLUSIONS: The created set has tested to be feasible, reliable, and useful, with the capacity to serve as the baseline for developing the necessary strategies to improve the management of chronic nonmalignant pain, by monitoring and evaluating quality of care.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Indicadores de Qualidade em Assistência à Saúde / Dor Crônica / Manejo da Dor Tipo de estudo: Guideline / Prognostic_studies Limite: Female / Humans Idioma: En Revista: Pain Pract Assunto da revista: NEUROLOGIA / PSICOFISIOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: México País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Indicadores de Qualidade em Assistência à Saúde / Dor Crônica / Manejo da Dor Tipo de estudo: Guideline / Prognostic_studies Limite: Female / Humans Idioma: En Revista: Pain Pract Assunto da revista: NEUROLOGIA / PSICOFISIOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: México País de publicação: Estados Unidos