Doug Brunk is with the San Diego bureau of Elsevier Global Medical News.
Chronic pain is a significant public health problem that must be viewed as a distinct chronic illness, according to a report by a multidisciplinary panel of pain experts.”
“Chronic pain is a chronic illness with the same level of import as any other common, challenging, extensive chronic illness faced by the American public, [such as] diabetes and cancer,” Russell K. Portenoy, MD, a cochair of the panel, said during a teleconference.
The 15-page report, “A Call to Revolutionize Chronic Pain Care in America: An Opportunity in Health Care Reform,” is based on recommendations from a meeting of pain experts who assembled in Washington, D.C., in June 2009.
The report, which is available for free download at www.maydaypainreport.org, outlines the impact of chronic pain in America and highlights the current challenges of effective care delivery. It also includes recommendations for the medical community, government agencies, and Congress to address.
More than 70 million Americans experience some form of chronic pain such as back pain, migraines, and joint pain, said Lonnie Zeltzer, MD, the panel's other cochair, who directs the pediatric pain program at Mattel Children's Hospital at the University of California, Los Angeles. “We're really facing an epidemic of undertreated pain.”
“Both the training received by the clinicians and the system of care should facilitate best practices in care,” said Dr. Portenoy, a neurologist who chairs the department of pain medicine and palliative care at Beth Israel Medical Center, New York. “Unfortunately, this is not currently the way it is.”
One of the report's nine recommendations is that licensing examinations should include assessment of clinical knowledge related to appropriate pain care.”
Another calls for coordinated information technology systems through which “the public should gain access to information on the performance of hospitals, doctors, and other health care providers.”
The report also proposes that the Department of Health and Human Services form an independent commission to “explore outcome-based payments for a team approach for selected cases, revision of the disparity between nonprocedural and procedural pain treatments, and parity for psychological services.”
The report and recommendations have been endorsed by several health care organizations, including the American Academy of Family Physicians, the American Academy of Pediatrics, the Joint Commission, the American Nurses Association, the American College of Emergency Physicians, and the American Academy of Neurology.
“This article is interesting and timely,” said AMDA's Clinical Affairs Chair Charles Cefalu, MD, CMD, of New Orleans. “Though I think that many primary care physicians are not trained to nor do they manage pain effectively, [long-term care] physicians do a good job of addressing pain as they see patients with chronic and comorbid conditions regularly in the nursing home and learn to manage them effectively. [I agree] that formal pain management training should be a component of medical student as well as residency training.”
The panel was convened by the New York City–based Mayday Fund, a private philanthropic organization focused on alleviating the incidence, degree, and consequences of physical pain.
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