Date of Publication

2023

Project Team

Dr. Margaret Aitken; Kristina DuPrat; Gracie Lanphear

Abstract

Background: Chronic pain is prevalent in the United States. Frequently, rural primary care providers must manage patients’ chronic pain and any associated long-term opioids. Best evidence-based practices recommend, and in some cases state guidelines require, periodic functional assessment, for which the CDC endorses the PEG assessment scale.

Purpose: To integrate the PEG assessment scale into a rural, primary care practice and evaluate sustainability in following best evidence-based practice guidelines.

Methods: A one-year retrospective chart review determined the baseline quality and frequency of functional assessment. A pre-implementation survey was distributed to providers to assess knowledge of opioid prescribing guidelines and their perceived applicability and importance to practice. The PEG assessment scale was implemented in a six-week series of PDSA cycles. Weekly retrospective chart reviews evaluated rate of completion. A post-implementation survey was sent to providers to gauge satisfaction and feasibility of continued use.

Results: Implementation increased the percentage of patients with chronic pain managed on long-term opioids with a validated and standardized functional assessment from 0% (N=95) pre-implementation to 63.53% (n=71). Providers endorsed the feasibility and sustainability of using the PEG assessment scale with intent to continue use after project completion.

Conclusions/Implications for Practice: Clinical staff supported utility of the PEG assessment scale despite not reaching the target average completion rate of 75%. The tool not only supports guideline compliant care but provides a more comprehensive assessment, helps open conversations about impacts of pain and goals of care, and helps direct changes in pain management regimens to support function.

Document Type

Project

Download

Share

COinS