Malama Ola—Taking Care of Your Well-Being


Sharin Sakurai Burton, MD, PhD; Casey Akana, RN; Sandra Tompkins, RN; Kristy Yoshikawa; Julia Gregory, RN; Hyewon Jun, MD; Mae Lynne Swoboda, MPH; Courtney Farris, MA, MINTee; John Banagan, MPH, CHES; Eric Kamimura, DPT; Steve Nakata, COTA, MBA; Derek Chee, DPT;
Quyen Nguyen, PhD; Jennifer Davis, RD; Kimberly Oshita, RD; Merle Miura-Akamine, MD; Kaipo Pau, MD; John Sheehan, MD

Abstracts from the Kaiser Permanente 2019 National Quality Conference

From Hawaii

Background: One person dies every 12 minutes of an opioid-related overdose. Our practitioners have decreased opioid utilization in chronic pain patients; however, recent guidelines for managing chronic pain emphasize nonopioid medications and access to complementary and alternative treatment protocols. Increasing function is now a focus of assessing therapeutic response to treatments for pain. Our patients with chronic pain need assistance with developing skills to increase their functional status while managing their pain with decreased opioid use.
Methods: Any patient with chronic (on opioid therapy for > 90 days) nonmalignant pain will be eligible for referral to the Malama Ola chronic pain wellness program. Those who enroll in the program will be offered access to complementary treatment options that emphasize self-care and increasing function. We will compare patients who enroll in the Malama Ola program to patients not enrolled in the program. Outcome measures include decrease opioid usage and increase function using the Brief Pain Inventory—Pain, Enjoyment, General Activity, Sleep questionnaire.
Results: With advice from the Patient and Family Center Care member advisors, we created Malama Ola, a chronic pain wellness center that is part of the Integrated Physical Rehabilitation clinic (staff include pain and physiatry practitioners). The patient is at the center of care. By removing the word “pain” from the clinic name we redirect the focus of opioid-based therapy to treatment-based on rehabilitation and integrated care. Patients with chronic pain can be referred directly to Malama Ola and a lifestyle coach navigates their care. We changed the name of our 6-week lifestyle program to active coping and training, which focuses attention on increasing function. Patients actively engage in self-care skills to increase function while managing pain that is not based only on opioids.
Discussion: Opioids are only 1 part of a multimodal treatment plan for chronic pain. Helping patients understand the mindset shift to increasing function and managing pain while reducing opioid use is a crucial part of managing pain. Member advisors from the Patient and Family Center Care committee were enlisted during the development of our Malama Ola class presentation and attended our first session. Their input allowed for more effective communication strategies to engage patients in our chronic pain wellness program. The next step is to develop patient-centered support groups with the Patient and Family Care Center to ensure sustainability of the self-care skills our members have learned.

Abstracts from the Kaiser Permanente 2019 National Quality Conference


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