Strategies to Better Management of Integrated Pain Programs

From NEJM Catalyst.

While Covid-19 has rightly grabbed the attention of health care organizations and policymakers, other health care challenges, like the opioid crisis, persist under the radar. Many people continue to suffer from poorly managed pain, and, in fact, may face additional challenges accessing quality and timely health care given that almost all non-urgent care is being delayed or foregone. While the health care system focuses on the current pandemic, it is important to avoid regressing on the nation’s recent progress in combatting opioid misuse and use disorders. In this article, we outline the ongoing challenges that health care organizations, payers, policymakers and providers must overcome in the current and post-Covid-19 era to deliver effective pain management, a component critical to fighting the opioid crisis.

Pain is a leading cause of disability in the US, with recent data showing that low back and neck pain account for the highest amount of annual health care spending ($134.5 billion in 2016) among all common medical conditions. These and other data strongly support the need for changes in the way we manage pain. Many recent attempts at pain management reform have come in response to the ongoing opioid epidemic, a response that has been likened to managing a house on fire. The most immediate need was to extinguish the fire, which naturally led to health care policies and interventions that were largely downstream such as encouraging change in prescriber behavior, addressing and managing opioid use disorder, and reducing opioid-related overdose and mortality.

Many recent attempts at pain management reform have come in response to the ongoing opioid epidemic, a response that has been likened to managing a house on fire.

Multiple national organizations and federal agencies, including a recent National Academy of Sciences workshop on Non-Pharmacological Approaches to Pain Management and the HHS Pain Management Best Practices Inter-Agency Task Force, are delivering a clear and consistent message: we have enough actionable evidence to pursue significant health care system change. These organizations and other national stakeholder groups have clearly outlined next steps. They include:

• Re-configuring health care delivery models
• Leveraging published clinical practice guidelines, such as those developed by the American College of Physicians for low back pain (LBP)
• Providing early non-pharmacological management

Integrated pain management (IPM), focused on individualized patient needs, has the ability to coalesce these steps into a cohesive strategy for action.

 

Read the journal article.

Other Categories:

• pain management

• pain policy