The impact of a nurse-led chronic musculoskeletal pain clinic on healthcare utilization

Musculoskeletal Care. 2012 Dec;10(4):196-201. doi: 10.1002/msc.1018. Epub 2012 Jun 13.

Abstract

Aims and objectives: To determine whether a nurse-led chronic musculoskeletal pain clinic for fibromyalgia patients can reduce utilization of healthcare services.

Background: People with fibromyalgia often consult multiple specialities due to the vast nature of their symptoms but receive little or no help in managing their symptoms.

Design: A retrospective evaluation of a nurse consultant-led chronic pain management clinic.

Methods: The frequency of hospital attendances in the five years before and three years after pain clinic attendance was evaluated. General practitioner (GP) attendances in the 12-month period before and after pain clinic attendance were compared with attendances for two groups of patients from an established GP cohort: (i) patients referred to rheumatology new patient clinics and (ii) all patients with fibromyalgia referred to any hospital new patient clinic.

Results: In the three years following attendance at the pain clinic, the mean number of hospital appointments fell significantly from 2.8 to 1.4 per annum (p < 0.001). The mean reduction seen in hospital clinic attendances in the first year (0.8/annum) improved in the second (1.2/annum) and third (2.1/annum) years. Seventy-eight per cent of pain clinic patients reduced their visits to their GP in the 12 months following treatment in the pain service, compared with 53% of patients referred to rheumatology clinics and 46% of patients with fibromyalgia.

Conclusion: A nurse-led chronic pain clinic for fibromyalgia patients can have a positive impact on primary and secondary healthcare utilization.

Relevance to clinical practice: Having a designated nurse-led pain clinic can enable patients to access the appropriate service at an earlier stage in their condition and receive the support needed to manage the impact of their pain.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Female
  • Fibromyalgia / nursing
  • Fibromyalgia / therapy*
  • Health Services / statistics & numerical data*
  • Health Services Accessibility
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Pain / nursing
  • Musculoskeletal Pain / psychology
  • Musculoskeletal Pain / therapy*
  • Nurse's Role*
  • Pain Clinics* / organization & administration
  • Referral and Consultation / statistics & numerical data
  • Workforce
  • Young Adult