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Report: Few Doctors Have Adequate Training to Effectively Treat Chronic Pain Patients

Authors offer recommendations (August 12)

Pain is the most common reason a patient sees a physician, but few physicians have received adequate training to help their patients, according to a new report from Henry Ford Hospital in Detroit, Michigan. The study was published in the Journal of the American Osteopathic Association.

An estimated 100 million people in the U.S. are living with chronic pain, which accounts for up to $635 billion in annual health care costs and lost productivity. A 2011 study found that for every medical specialist, there were more than 28,500 patients with chronic pain.

Consequently, pain management typically falls to primary care physicians, many of whom lack the skills to effectively treat pain. A recent survey of 117 U.S. and Canadian medical schools found that only four U.S. medical schools offered a required course on pain management.

“It’s a major health care problem,” said senior author Raymond Hobbs, MD. “We have physicians who have been well trained and have been practicing a long time, but didn’t receive training in pain management.”

Hobbs offers these recommendations to help physicians treat patients with chronic pain:

  • Work in collaboration with a team of specialists comprising primary care, physical, or occupational medicine, pain management and mental health.
  • Use a five-point risk-assessment tool to screen for substance abuse in patients being considered for oral opioid therapy, such as morphine, codeine, and fentanyl.
  • Set a threshold dose of 200 mg/day or less of oral morphine equivalents per day.
  • Follow the so-called Universal Precaution model, which calls for a complete medical evaluation and regular assessments of the four A’s of pain medicine: analgesia, activity, adverse effects, and aberrant behavior.

Source: Henry Ford Health System; August 12, 2013.

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