- The Institutes of Medicine (IOM) recommend an increase in patient-centered care techniques to help manage more than 100 million Americans experiencing chronic pain. As the danger of overdoses and deaths from opioid abuse becomes a nation-wide epidemic, better population health management is required to identify at-risk patients and provide individualized care to those with chronic conditions.
“Persons living with chronic pain have often been grouped into a single category, and treatment approaches have been generalized with little evidence to support this practice,” said Dr. David B. Reuben, panel chair and professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles. “Chronic pain spans a multitude of conditions, presents in different ways, and requires an individualized, multifaceted approach.”
Up to sixty percent of patients taking prescription opioids are at risk for adverse patient safety events due to poor medication reconciliation and a lack of electronic prescription monitoring. Those with chronic pain, the IOM says, may not experience the benefits of patient-centered care, such as an integrated, team-based approach to services and the use of clinical analytics tools to measure severity of pain, track the effectiveness of treatments, and prevent medication-related harm.
“We have inadequate knowledge about treating various types of pain and how to balance effectiveness with potential harms. We also have a dysfunctional health care delivery system that promotes the easiest rather than the best approach to addressing pain,” said Dr. Reuben.
Patients who become dependent on opioids often try their hand at “doctor shopping,” or seeing multiple providers for the same issue to increase their chances of getting a prescription for their controlled substance of choice, and may try to fill the orders at multiple pharmacies. Electronic monitoring databases in nearly every state are harnessing the power of data analytics to flag patients who may be engaging in these behaviors, but are not always as effective as law enforcement could like.
The IOM research panel recommends that physicians take the lead in managing chronic pain before it leads to opioid dependence. The researchers suggest that in addition to more academic investigation into the effect of patient-centered care on pain management, EHR and clinical analytics developers should create and integrate better pain management tools and clinical decision support features into their products to ensure that patients are receiving the correct medications and treatments for their conditions.