The Latino Integrative Medical Group Visit (IMGV) as a model to reduce pain in underserved Spanish speakers: a pilot feasibility study
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BACKGROUND: Disparities in access to quality chronic pain treatment options disproportionately affect minorities. Although there is increasing evidence about the effectiveness of complementary and integrative medicine (CIM) to help in the treatment of pain, little is known about how low income minorities would benefit from having greater access to CIM. The Integrative Medical Group Visit (IMGV) model incorporates CIM in a medical group visit setting with the goal of increasing access to CIM. OBJECTIVE: The aims of this pilot study were to test 1) the feasibility of a Spanish language IMGV and 2) its effectiveness to reduce pain and improve function in Spanish speakers with chronic pain. METHODS: The study setting is the Family Medicine Clinic at Boston Medical Center. Adult Spanish speakers with chronic pain for at least 12 weeks were included; those pregnant, with psychosis, suicidal ideation or active substance abuse disorder were excluded. The intervention consisted of weekly, two-hour sessions for a total of 9 weeks. Main outcomes were pain level, pain interference, and physical and emotional function measured by the PROMIS 29 pre- and post-intervention, depression and stress, measured by PHQ-8 and PSS-10, respectively. Focus group participants discussed the feasibility of the intervention. Analyses involved t-tests to examine our outcome data, and qualitative thematic analysis for focus group data. RESULTS: This open study recruited 11 subjects, 10 women, average age of 51.9 years; 50% of participants attended more than four sessions. The outcomes showed a trend toward reduced depression, pain, fatigue, and anxiety. Qualitative themes of reduced pain, increased knowledge for healthier living, and improved access to pain treatment using an appropriately adapted intervention were found. CONCLUSIONS: It was feasible to implement the Latino IMGV model in the outpatient setting at BMC. Trends in reduction of pain and depression, as well as increased knowledge for healthier living and better access to CIM modalities were found. Future powered studies are needed to further implement this model.