Case Series Open Access
Volume 3 | Issue 1 | DOI: https://doi.org/10.33696/AIDS.3.012

From Silos to Solidarity: Case Study of a Patient-Centered, Integrative Approach to Opioid Tapering and Chronic Pain Mitigation in a Multidisciplinary AIDS Clinic

  • 1Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, United States
  • 2Emory University School of Medicine, Department of Medicine, Division of Infectious Diseases, Atlanta, GA, United States
  • 3Emory University Rollins School of Public Health, Department of Global Health, Atlanta, GA, United States
+ Affiliations - Affiliations

Corresponding Author

 Sara Pullen, sara.pullen@emory.edu

Received Date: November 25, 2020

Accepted Date: January 28, 2021


Background: People with HIV (PWH) are at a disproportionate risk for experiencing both chronic pain and opioid use disorder (OUD). Prescription opioid tapering is typically addressed within the “silo model” of medical care, whereby attention is focused solely on opioid addiction rather than also addressing chronic pain management, and limited communication occurs between patient and providers.

Objective: This descriptive case study examined an integrative, collaborative care model consisting of Provider, Physical Therapist (PT), and Patient aimed at decreasing chronic pain and opioid use within a multidisciplinary HIV/AIDS clinic.

Method: A physical-therapy based model of chronic pain mitigation and physician-driven opioid tapering was implemented. The Provider, PT, and Patient worked collaboratively to address physiological pain, pain coping skills and opioid tapering. A patient case example was used to illustrate the implementation of the model for a future, larger study in the same patient population.

Results: This model was feasible in this case example in terms of clinic workflow and acceptability to both the Patient and Providers in this clinic. After the intervention, the Patient’s pain was fully eliminated, and he had ceased all opioid use.

Conclusion: Results of this case study suggest that utilizing an integrative, patient-centered approach to both chronic pain management and opioid tapering may be feasible within the context of a multidisciplinary HIV/AIDS clinic. Generalizability is limited by case study model; however, this gives insight into the value of a collaborative alternative compared to a “silo” model of opioid tapering and chronic pain management in preparation for a larger study.


HIV, AIDS, Chronic pain, Opioids, Physical therapy

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