Chronic pain affects 116 million Americans and costs the U.S. as much as $635 billion each year, according to a new report from the Institute of Medicine (IOM) that called for changes in how chronic pain is managed.
Much of the chronic pain experienced by Americans isnÕt treated correctly, in part because doctors are not taught in medical school how to help patients manage pain, according to the report, entitled ÒRelieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research,Ó which was mandated by the healthcare reform law.
Chronic pain is so widespread and poorly understood that itÕs a public health issue and a major Ònational challenge,Ó concluded the Committee on Advancing Pain Research, Care, and Education, which was made up of 18 experts in pain management, anesthesiology, bioethics, statistics, and immunology.
ÒGiven the large number of people who experience pain and the enormous cost in terms of both dollars and the suffering experienced by individuals and their families, it is clear that pain is a major public health problem in America,Ó said committee chair Philip Pizzo, MD, professor of microbiology and immunology at Stanford University School of Medicine, in a press release.
Chronic pain is Òmore than a physical symptomÓ and can be influenced by genetics, stress, depression, and behavioral, cultural, and emotional factors, the committee wrote.
Moreover, long-term, persistent pain, which may have been caused by an injury or a disease, can cause changes in the nervous system, which in turn cause the pain to become its own distinct chronic disease.
The report called for a cultural change in order to prevent, assess, treat and understand all types of pain and laid out a blueprint for providing relief from pain.
It directs the Department of Health and Human Services to develop a plan to increase awareness about pain and its health consequences; improve how pain is assessed in the healthcare setting and how treatment of pain is paid for by the federal government; and to address disparities in how different groups of people experience pain.
It also called for the National Institutes of Health to designate a lead institute tasked with Òmoving pain research forward,Ó and it called for coordinated efforts between public and private organizations to create recommended changes to how chronic pain is managed.
The committee said that while pain is prevalent, the full scope of the problem is unclear, especially among groups of people where pain might be underdiagnosed and underrated, including minorities, women, children, the elderly, military veterans, and people who are at the end of life. More data should be collected to study trends over time and to pinpoint certain populations at risk for chronic pain, the committee wrote.
The panel offered some advice for doctors as well: Primary care physicians should collaborate with pain specialists in cases where a patientÕs pain persists even after treatment. The committee acknowledges that healthcare providers need to be better educated about how to understand pain and its causes, especially primary care doctors who are often the first stop for patients seeking treatment for chronic pain.
The report recommends healthcare providers engage in continuing education programs, and that licensure, certification, and recertification should include assessment of providersÕ knowledge of pain management.
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