• Can J Anaesth · Jul 2022

    Frequency and characteristics of patient exclusion criteria in Canadian multidisciplinary pain treatment facilities: a cross-sectional study.

    • Lise Dassieu, Manon Choinière, Laurence Saint-Jean, Fiona Webster, Philip Peng, Norm Buckley, Ian Gilron, Owen Williamson, G Allen Finley, Krista Baerg, Audrée Janelle-Montcalm, Maria Hudspith, Aline Boulanger, Tania Di Renna, Howard Intrater, Brenda Lau, and John Pereira.
    • Research Center of the Centre Hospitalier de l'Université de Montréal, Saint Antoine Building, 850 Saint Denis Street, Montreal, QC, H2X 0A9, Canada. lise.dassieu@umontreal.ca.
    • Can J Anaesth. 2022 Jul 1; 69 (7): 849858849-858.

    PurposeA multidisciplinary approach is recommended for patients with complex chronic pain (CP). Many multidisciplinary pain treatment facilities (MTPFs) use patient exclusion criteria but little is known about their characteristics. The objective of this study was to describe the frequency and characteristics of exclusion criteria in public Canadian MTPFs.MethodsWe conducted a cross-sectional study in which we defined an MPTF as a clinic staffed with professionals from three disciplines or more (including at least one medical specialty) and whose services were integrated within the facility. We disseminated a web-based questionnaire in 2017-2018 to the administrative leads of MPTFs across the country. They were invited to complete the questionnaire about the characteristics of their facilities. Data were analyzed using descriptive statistics and correlation measures.ResultsA total of 87 MTPFs were included in the analyses. Half of them (52%) reported using three exclusion criteria or more. There was no significant association between the number of exclusion criteria and wait time for a first appointment or number of new consultations in the past year. Fibromyalgia and migraine were the most frequently excluded pain syndromes (10% and 7% of MPTFs, respectively). More than one MPTF out of four excluded patients with mental health disorders (30%) and/or substance use disorders (29%), including MPTFs with specialists in their staff.ConclusionsMultidisciplinary pain treatment facility exclusion criteria are most likely to affect CP patients living with complex pain issues and psychosocial vulnerabilities. Policy efforts are needed to support Canadian MPTFs in contributing to equitable access to pain management.© 2022. Canadian Anesthesiologists' Society.

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