Duke Health Integrated Pain and Wellness Program — A Proactive Population Health Model
The Duke Integrated Pain and Wellness (IPW) program integrates early identification and stratification of patients at risk for poor pain outcomes, leveraging a validated two-question screening tool across select Duke Health primary and multispecialty clinics. This enables early referrals for comprehensive risk stratification and personalized treatment plans aimed at modification of risk factors for poor pain-related outcomes. The IPW program’s shift to a proactive, integrative pain management model focuses on early intervention, customized treatments, and patient feedback to improve both pain management and the patient’s psychological and functional well-being. The authors describe the impact of the effort, which has led to improvement in patient-reported outcome measures related to both pain scores and average Pain Catastrophizing Scale scores; improved levels of anxiety, fatigue, pain interference, pain intensity, and the ability to participate in social roles; reduced negative thought patterns related to pain; and a reduction in both ED visits and hospital admissions. Although the authors note the need for further research efforts focused on prospective studies with control groups and long-term follow-up to validate the effectiveness of the IPW program’s approach and to ensure the sustainability of the improvements, the early results reflect the effectiveness of the IPW program’s interventions — coordinated by a care team triad featuring a pain specialist physician, an advanced practice provider, and a licensed clinical social worker — in managing chronic pain and reducing acute care usage.
