Improving virtual integrative medical group visits for patients with chronic pain: Lessons learned during the COVID-19 pandemic

Objective: The COVID-19 pandemic prompted implementation of the Integrative Medical Group Visit (IMGV) intervention to transition from a face-to-face format to telehealth delivery This billable, evidence-based program offers adapted mindfulness-based stress reduction and chronic-pain self-management experientials (acupressure, self-massage, and chair yoga) to patients with chronic pain This study assesses common barriers and facilitators to participation in a telehealth IMGV Using participant feedback, we evaluate how the transition to an internet-based video conferencing platform can enhance or detract from the delivery and accessibility of this integrative chronic pain program Methods: Semi-structured phone interviews were conducted with eight adult participants (ages 31 to 57) who completed a nine-session, weekly 2-hour telehealth IMGV led by a physician and a certified yoga teacher via Zoom Video Communications The mean attendance was 6 sessions, with attendance ranging from 3 to 9 sessions Participants reflected on their experiences, the extent of their participation, and potential areas of improvement All interviews were recorded, transcribed, and inductively coded for barriers and facilitators to telehealth delivery Results: Participant reported facilitators to participating in the telehealth IMGV program included feeling safer at home during the pandemic, ease of participation, socialization during pandemic-associated social isolation, and no need to find transportation or childcare in comparison to inperson visits Barriers included feeling uncomfortable with technology, content not targeting virtual audiences, concerns about finding private spaces to participate, and lack of motivation to retain involvement in an online program Conclusion: Telehealth IMGV programs are uniquely poised to provide services for patients with chronic pain, as they can alleviate barriers to care associated with transportation, mobility, and childcare Current telehealth IMGV programs, however, can improve by incorporating more technical information about how to navigate telehealth platforms while also offering a curriculum that specifically includes internet-based, group activities to motivate participation in an online community