The UCSF Osher Center for Integrative Medicine is partnering with the San Francisco Department of Public Health’s Tom Waddell Urban Health Center in the Tenderloin neighborhood to study the effect of integrative medicine interventions on underserved patients with chronic pain. Many patients at the Tom Waddell Urban Health Center face challenges from chronic disease, substance use, mental illness, poverty, social isolation and a history of multiple traumatic life events, and through this pilot program, the treatment plan for chronic pain will include such interventions as acupuncture, massage therapy, physical therapy, meditation, yoga, and Qi Gong.
This partnership, called the Integrative Pain Management Program (IPMP), was created because of a community-identified opiate problem, as well as the recognition that addressing the complex problem of chronic pain management among vulnerable patients requires input from multiple perspectives.
Chronic pain, which can severely impact daily functioning and quality of life, can be difficult to manage, particularly among vulnerable populations, who have a higher prevalence of pain. Opioid prescriptions in the US have nearly tripled in the past two decades, and deaths from prescription opioid overdose now outnumber deaths from illicit substance use. (Read the CDC report.) San Francisco’s death rate from prescription opioid overdose is more than twice the national average, with the greatest concentration of deaths occurring in neighborhoods with high rates of poverty and single room occupancy hotels.
This research study will measure changes in patients’ pain intensity and health-related quality of life (physical, psychological, and social functioning), in addition to any changes in the amount of opioid medications. Data will also be collected on the number of referrals, attendance, and adherence to the program, as well as qualitative data on patient experiences and satisfaction with the program. The study will also examine the preliminary effects of the program on the healthcare providers caring for chronic pain patients, including providers’ experiences, burnout, and satisfaction. It is scheduled to run from February through November of 2016, with three cohorts of 25 people, for three months each.
The Lead Physician for the program is Barbara Wismer, MD of the Tom Waddell Urban Health Center. Maria Chao, DrPH, core research faculty at the UCSF Osher Center for Integrative Medicine, is the Principal Investigator. The Steering Committee is comprised of 21 members, including SFDPH leaders, safety net clinic providers, experts in multidisciplinary approaches to pain management, and academic researchers. Rick McKinney, MD, an integrative medicine family physician at the UCSF Osher Center and San Francisco General Hospital, is also serving on the Steering Committee.
Funding has generously been provided by the UCSF Mount Zion Health Fund, in-kind support from the San Francisco Department of Public Health, and through the National Institutes of Health/National Center for Complementary and Integrative Health (NIH/NCCIH), who has funded Dr. Chao through a K01 Mentored Career Development Award.