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Depression and Heart Disease

Improving access to care for chronic pain patients

There are a lot of people in Canada who suffer from chronic pain in fact the numbers are approximately one in five. It’s estimated that treating chronic pain costs the system more than six billion dollars annually in Canada, more than heart disease, cancer, and HIV combined. The Toronto Academic Pain Medicine Institute or TAPMI is a partnership between the five academic pain medicine hospitals in downtown Toronto. So Women’s College Hospital, St. Michael’s Hospital, University Health Network, Sinai Health Systems and the Centre for Addiction and Mental Health. And these five centres have partnered to improve care for chronic pain patients in the GTA and they’ve done this through forming a centralized hub and spoke model with the hub of services located at Women’s College Hospital. A key part of the hub and spoke model is going to be the central intake and triage. So primary care providers are going to be able to refer their patients into a single point of access and then we at TAPMI can decide which program or services among the five partner sites is most suited for that patient’s particular needs. The referral will get to the correct place the first time and the family doctor doesn’t need to have knowledge about what each clinic does, we figure out where the patient needs to go. What makes this program unique is that in addition to the centralized hub and spoke referral network is that we have a hub of services located at Women’s College Hospital. Instead of having five programs across downtown Toronto that do essentially the same thing, we now have one central place for patients to have access to these resources regardless of which site they’re being treated at. The foundational services include patient education, cognitive behavioral therapy group sessions, physiotherapy group sessions. They’ll have access to a pharmacist if they’re interested in opioid-weaning, a social worker if they require some motivational interviewing. It’s fabulous to have all the services offered in one place at Women’s College Hospital. It allows me to come here one place instead of traveling to many over different days or different times and be able to access the service and I start to feel like I belong here and I’m welcomed here. Having a centralized hub of care allows us to provide more services to more patients with fewer health care dollars spent. About 15 years ago I was diagnosed with fibromyalgia. It’s been a long journey with pain. Chronic pain patients are often stigmatized and marginalized. They’re usually embarrassed to have chronic pain so they’re definitely a hard to reach population. They’re afraid that if they go in to see their primary care provider they won’t be believed. I’m in chronic pain. I’m exhausted all the time but I look completely fine. You can’t really see what chronic pain is and so a lot of people in the community don’t really understand the impact that it can have on your life. This program through all of the research that they present to us and the discussion we have, it really does make me realize that I it’s real and I have real pain. Foundational pain services is trying to focus on the person and how they live their daily life rather than focusing just on the illness. The patient will have kind of a holistic look at their illness. We’re trying to teach patients skills. Their support and guidance through all of this and teaching me exactly what fibromyalgia is and what I can do help myself live with all this pain it’s just been very helpful in encouraging me and teaching me to have compassion for myself while dealing with constant pain and exhaustion. It’s taught me to pace myself and listen to my body. When the patients are discharged they are then connected with their community provider so that we can continue the concepts that they’ve learned at TAPMI for the rest of their lives.

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