Abstract
Objective
Health coaching has shown promise in helping patients manage their chronic disease and in improving health outcomes, yet the implementation of health coaching in healthcare systems is understudied. Further, evidence suggests that interdisciplinary care teams may be more effective in treating chronic pain than usual care. As such, we sought to examine the benefits and drawbacks to embedding health coaches within interdisciplinary pain care teams (“Whole Health Teams”).
Design
As part of a multisite clinical trial (at five Veterans Health Administration sites) investigating the effectiveness of a Whole Health Team (WHT) approach to care for patients with chronic pain, qualitative interviews gathered data on how the experience of treating patients in the WHT differed from the experience treating patients outside the WHT, as well as provider experiences coordinating patient care within the WHT.
Participants
Twenty-two WHT members, study investigators, and study coordinators.
Approach
Data were analyzed using a rapid analysis approach.
Results
Overall, stakeholders perceived considerable synergy within the interdisciplinary pain care team. Each provider brought a different perspective to the patient’s health concerns, which stakeholders felt was valuable and increased patient progress towards goals. The team model was also viewed as efficient because everyone was committed to working together and communicating as a team. Logistically, however, stakeholders noted challenges to working as a team, especially regarding patient goal setting. Furthermore, multiple stakeholders believed the care team model required a high degree of dedication to teamwork and communication among its members to be successful.
Conclusions
Embedding health coaches within interdisciplinary pain care teams may improve care processes and accelerate patient progress. Successful implementation would require adequate training, role clarification, and expectation setting to facilitate good communication across all care team members. Additional research is needed to evaluate the clinical outcomes of integrating health coaches on WHTs versus other implementation approaches.
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Acknowledgements
This manuscript is a product of the NIH-DoD-VA Pain Management Collaboratory. For more information about the Collaboratory, visit https://painmanagementcollaboratory.org. The work was also supported with resources and the use of facilities in the Veterans Health Administration.
Funding
Research reported in this publication was made possible by Grant Number U24 AT009769 and cooperative agreement UH3AT009765 from the National Center for Complementary and Integrative Health (NCCIH), and the Office of Behavioral and Social Sciences Research (OBSSR).
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Denneson, L.M., Purcell, N., McGrath, S.L. et al. Integration of Health Coaches in a Whole Health Team Model of Chronic Pain Care: a Qualitative Study. J GEN INTERN MED 38, 3574–3580 (2023). https://doi.org/10.1007/s11606-023-08317-x
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DOI: https://doi.org/10.1007/s11606-023-08317-x