Hub-and-Spoke Models of Care for Chronic Pain

Key Messages

• Four reports describing the potential clinical benefits of hub-and-spoke models of care for chronic pain were included in this report:
  • The single arm pre- and post- study of the Manage Your Pain Program described its impact on pain, depression, anxiety, and health-related quality of life.
  • The retrospective cohort study of the Army and Navy Extension of Community Healthcare Outcomes Pain described pharmacotherapy use.
  • The single-arm pre- and post-study of the Extension of Community Healthcare Outcomes Pain in the University Health Network described pain, depression, and pharmacotherapy and health care use.
  • The comparative pre- and post-study of the Extension of Community Healthcare Outcomes Pain in community health care centres described pharmacotherapy and health care use.
• While all of the referenced models included central specialized care by hubs and core services by spokes, and the use of videoconferencing to provide chronic care education, the models were tailored, and the evaluation methods were heterogeneous.
• No reports were identified that described the potential harms or the potential cost implications of hub-and-spoke models for the delivery of care for chronic pain.