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 Ineffective Pain Care Costs Americans More Than $100 Billion Annually

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Date d'inscription : 15/05/2008

MessageSujet: Ineffective Pain Care Costs Americans More Than $100 Billion Annually   Mar 27 Oct - 16:21

A new Pain Medicine Position Paper published by leaders of the American
Academy of Pain Medicine (AAPM), reveals businesses lose $61 billion
annually due to ineffective pain care and the lack of optimal pain care
delivery. Leaders from the organization are now implementing and
teaching a new, "population-based" approach to delivering care with the
goal of alleviating pain so patients can get on with their lives.

AAPMedicine's President Rollin M. Gallagher, MD MPH comments, "Pain
affects everyone, and for many millions, pain becomes chronic, a
scourge that affects every part of their lives--their work, their
hobbies, their friendships, their families, their sex, their fun, their
finances, their mood, and even their fundamental sense of identity, who
they are. According to the National Institutes of Health, pain is one
of our most important national health problems, costing the American
public more than $100 billion each year in health care, compensation
and litigation. The AAPMedicine's Position Paper offers solutions that
will fundamentally change the way pain is approached in the health care
system. The Paper proposes a population-based approach to pain
management that will both improve the competency of the health care
system to manage pain for the millions of patients suffering needlessly
in hospitals with acute pain and on into their lives with chronic pain,
and will also reduce the cost of pain to our society. People will be
able to work who couldn't work before. People who work will work
longer, better and more productively. People with terminal cancer
will die in comfort, preserving their personal dignity and mitigating
the emotional suffering of their families. The Proposal is consistent
with the medical home approach being fostered as a solution to the
problems besetting our health care system, an approach that emphasizes
patient responsibility, early effective treatment, and when pain
becomes chronic, competent longitudinal treatment, what we call
'chronic illness management'."

A population-based approach to pain includes stepped care that is
designed to deliver timely access to levels of care that are needed to
prevent chronic pain from beginning, or when pain persists, minimizing
morbidity through effective care:

Step One: Prevention of disease or injury with the use of
evidence-based self-care, such as diet, exercise, ergonomics
(alteration of work activities) or cessation of smoking and other drug
abuse to reduce the risk of injury or disease.

Step Two: If self-care is not working, patient will then visit their
primary care physicians for evaluation and management using
evidence-based algorithms.

Step Three: If disabling pain persists, the patient will be referred to
a pain medicine specialist who will collaborate with a team of
providers, including, nurse case managers, psychologists and physical
therapists.

Step Four: If the patient remains in disabling pain, he or she will be
referred to a pain medicine specialist within a subspecialty of care.

Currently there is no unified organizational model of pain medicine,
which has led to ineffective and fragmented pain care with poor
outcomes and higher costs than necessary. This fragmentation threatens
patient safety and causes the passing of a patient from doctor to
doctor for a diagnosis and pain treatment, even though that doctor may
have had minimal or even no specific training in chronic pain
management. The Academy believes one of the solutions to this complex
problem is the establishment of Pain Medicine as a recognized primary
medical specialty. This recognition would allow Pain Medicine's
specialized knowledge, education, training, and multidisciplinary
approach to provide standardized training for all physicians and
integrated and comprehensive pain care to millions of Americans
suffering with acute, cancer and chronic pain.

One segment of society that has carried the burden of an ineffective
pain care delivery system is the business community. It is estimated to
cost $61.2 billion annually in lost productive time. The majority of
this cost (76.6%) is attributed to reduced performance while at work,
not work absence. During the course of two weeks, 13 percent of the
total workforce experienced a loss in productive time due to a common
pain condition. An estimated 3.8 billion hours of work are also lost
annually due to pain.

As the largest purchasers of healthcare, businesses have much to lose
from ineffective pain treatment of their employees. Finding a unified
approach to pain medicine is critical. Back pain alone cost businesses
$19.8 billion in lost productive time, with almost three-quarters of
the cost attributed to complications of back pain from the lack of
proper care.

"The ineffective treatment of pain results in an escalating cascade of
health care issues. Acute pain that is not treated adequately and
promptly results in persistent pain that eventually causes irreversible
changes in the brain and spinal cord. This is referred to as
neuropathic pain, a neurobiological disorder that is difficult to
diagnose and manage. Persistent pain of this nature often results in
further bio-psycho-social changes, which in turn result in further pain
and increasing disability. This vicious cycle transforms a human being
into a patient who unwittingly becomes a burden to himself, his family
and society at large. The emotional, societal and financial costs are
immeasurable," according to AAPMedicine's Executive Medical Director,
Philipp M. Lippe.

Currently there are not enough pain medicine specialists to treat back
pain and other pain conditions, and the system for training physicians
in the discipline of pain medicine remains insufficient. The Academy's
solution calls for better residency training programs in pain medicine,
which will lead to better and more cost-effective pain care.

Recognizing pain medicine as a primary medical specialty would also
increase federal funding into pain research. As the population ages,
there will be an increased need for physicians who have both specific
expertise in pain medicine and broader training in the needs of an
aging population. An increase in federal funding for pain research is
critical to keep pace with the growing problem of pain in America.

Taking these steps will also improve health care coverage for pain
care. Insurance companies often refuse to cover pain-relieving
treatments, and access to pain rehabilitation is non-existent in many
parts of the country. The Veteran's Affairs' medical system has
recognized the need for change in pain care and now requires VA health
care institutions to provide organized pain assessment and management.
Developing an optimal system of pain care delivery would not only
address better healthcare for the millions of Americans in daily pain,
but its benefits would filter down to both businesses and society.
Safe, effective and affordable pain treatment is possible, and the
benefits are immeasurable. Click here to view the Pain Medicine
Position Paper.


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