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Preliminary outcomes of a pilot physical therapy program for HIV-infected patients with chronic pain

机译：艾滋病毒感染的慢性疼痛患者的物理治疗试验计划的初步结果

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Chronic pain in HIV-infected individuals is common and often undertreated. Physical therapy (PT) is an evidence-based nonpharmacologic treatment for chronic pain. Our objective is to present the results of a pilot PT program in an HIV pain/palliative care clinic, which is embedded within a Ryan White-funded multidisciplinary HIV primary care clinic. Medical records of HIV-infected patients participating in a PT program between November 2012 and July 2013 were retrospectively reviewed. Pain scores on a 0-10 scale and cost data were collected and analyzed. Among 43 patients referred, 27 collectively attended 86 sessions. Median age of enrolled patients was 54 (IQR 49-58). Sixteen (59%) were African-American and 20 (77%) had an undetectable HIV viral load. Mean pain score at initial visit was 6.5 (SD = 1.1). The average session-level decrease was 2.6 (SD = 1.7) and patient-level decrease was 2.5 (SD = 1.2). The largest payors were Medicare managed care (28%), Medicaid (21%), and Ryan White grant-related funds (18%). When the first four months of the program are excluded to account for slow start-up, the program's monthly net revenue during the remaining five months was $163. We present preliminary data from a low-cost pilot PT program integrated into an HIV clinic in a primary care setting associated with clinically significant improvements in pain. Further investigation into the implementation of such programs is essential.
机译：艾滋病毒感染者的慢性疼痛很常见，而且常常得不到充分的治疗。物理疗法（PT）是一种基于证据的慢性疼痛非药物疗法。我们的目标是介绍在HIV疼痛/姑息治疗诊所进行的PT试点项目的结果，该诊所嵌入了Ryan White资助的多学科HIV初级保健诊所。回顾性分析了2012年11月至2013年7月间参加PT计划的HIV感染患者的病历。收集并分析0-10级疼痛评分和费用数据。在转诊的43位患者中，有27位集体参加了86次治疗。入组患者的中位年龄为54岁（IQR 49-58）。 16名（59％）是非裔美国人，20名（77％）的HIV病毒载量无法检测。初诊时的平均疼痛评分为6.5（SD = 1.1）。平均会话水平降低为2.6（SD = 1.7），患者水平降低为2.5（SD = 1.2）。支付额最大的是医疗保险管理的医疗（28％），医疗补助（21％）和瑞安·怀特（Ryan White）赠款相关的基金（18％）。如果排除该计划的前四个月以解决启动缓慢的问题，则该计划在剩余五个月中的月净收入为163美元。我们提供了从低成本试点PT计划中获得的初步数据，该计划已在与临床上明显改善的疼痛相关的基本医疗服务中整合到了HIV诊所中。必须进一步调查此类方案的执行情况。

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