Changes in Interventional Pain Physician Decision-Making, Practice Patterns, and Mental Health During the Early Phase of the SARS-CoV-2 Global Pandemic

Abstract Background and Objectives The novel coronavirus outbreak (SARS-CoV-2) began in late 2019 and dramatically impacted health care systems. This study aimed to describe the impact of the early phase of the pandemic on physician decision-making, practice patterns, and mental health. Methods An a...

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Bibliographic Details
Published in:Pain Medicine 2020-12, Vol.21 (12), p.3585-3595
Main Authors: Joyce, Andrew A, Conger, Aaron, McCormick, Zachary L, Kendall, Richard W, Wagner, Graham, Teramoto, Masaru, Cushman, Daniel M
Format: Article
Language:English
Subjects:
Acetaminophen
Adult
Care and treatment
Clinical Decision-Making
Coronaviridae
Coronaviruses
COVID-19
Decision making
Epidemics
Female
Health care
Humans
Male
Medicine
Mental Health
Middle Aged
Muscle relaxants
Narcotics
Neuralgia
Opioids
Original
Pain
Pain management
Pain Management - methods
Pandemics
Patients
Physicians - psychology
Practice
Practice Patterns, Physicians
Risk groups
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Social aspects
Surveys and Questionnaires
Telemedicine
United States
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Summary:Abstract Background and Objectives The novel coronavirus outbreak (SARS-CoV-2) began in late 2019 and dramatically impacted health care systems. This study aimed to describe the impact of the early phase of the pandemic on physician decision-making, practice patterns, and mental health. Methods An anonymous survey was distributed to physician members of the Spine Intervention Society (SIS) on March 24 and April 7, 2020. Respondents provided information regarding changes in clinical volume, treatment, and mental health (Patient Health Questionnaire [PHQ-4]) before April 10, 2020. Results Of the 1,430 individuals who opened the survey, 260 completed it (18.2%). Overall clinical and procedural volume decreased to 69.6% and 13.0% of prepandemic volume, respectively. Mean in-person clinic visits were reduced to 17.7% of total prepandemic clinic volume. Ongoing clinical visits were predominantly completed via telemedicine (video) or telephone (74.5%), rather than in-person (25.5%). Telemedicine and telephone visits represented 24.6% and 27.3% of prepandemic clinical volume, respectively. Respondents decreased in-person visits of select groups of high-risk patients by 85.8–94.6%. Significantly more providers reported increasing rather than decreasing prescriptions of the following medications: opioids (28.8% vs 6.2% of providers, P 
ISSN:1526-2375
1526-4637
DOI:10.1093/pm/pnaa294