The epidemic of untreated chronic or recurrent pain has lasted for decades, yet millions of people are still not adequately treated. One significant barrier to effective pain management is that clinicians and patients are often reluctant to talk about pain. Oftentimes, patients with pain believe their complaints aren’t taken seriously by their healthcare providers or they’re concerned about becoming addicted to certain pain medications. Many physicians also have difficulty managing pain, which can then have an impact on patient care and management. Some doctors have concerns or reservations about their ability to manage pain appropriately, the potential for substance abuse and addiction, or regulatory scrutiny.
There is a significant knowledge deficit in the management of pain, especially when it comes to treatment options and the potential harms associated with available therapies. The unintended or undesirable side effects related to pain treatment can have a negative impact on patients, ranging from minor to life-threatening adverse events. Patient perceptions of side effects can also play a role. In some cases, patients may abandon their treatment due to side effects, even though these therapies have the potential to reduce pain and suffering and improve quality of life and physical function.
“There is a significant knowledge in the management of pain, especially when it comes to treatment options and potential harms associated with available therapies.”
Education is Critical
No single treatment option for pain management is without risk, but physicians must also consider the risks involved with making decisions to not treat pain. There is a general lack of education in medical schools and during residency training on pain management. Many of the risks associated with pain treatment can be managed by educating and empowering providers about the safe use of interventions. Efforts to minimize the risks of overdose and death are essential. To reach this goal, physicians must learn about the safe and effective use of pain therapies. Doing so will make more treatment options available for more patients living with pain.
The PainSAFE Initiative
The PainSAFE initiative (http://www.painfoundation.org/painsafe) is a multi-pronged educational program designed to help advocate for and advance the safe use of all pain therapies. With guidance from a multidisciplinary advisory committee of pain and addiction experts and the American Pain Foundation, PainSAFE provides up-to-date information, programming, and practical resources and tools on pain. Physicians can use the website as a central hub of evidence-based information and practice-based tools to focus their management of pain safely and help reduce the risks that are associated with various pain therapies and interventions.
When the PainSAFE initiative was rolled out, one of the first pain management issues addressed was the safe use of prescription opioids. The website provides webinars, educational materials, and symposia to help physicians learn more about this important topic within pain management. In the future, there are plans to explore other therapies and interventions for pain (eg, patient-controlled analgesia), to identify potential harms and risks of those treatments, and to investigate systems approaches to improve the safety of pain therapies. There are also plans to evaluate the PainSAFE initiative to demonstrate validity and its real world impact. The results of these evaluations will help guide the evolution of the program to address the latest issues relating to patient safety. Ideally, PainSAFE will become the gold standard for informing clinicians on pain and how to treat it safely.
American Pain Foundation. PainSAFE. Available at: www.painfoundation.org/painsafe.
American Pain Foundation. Physician Perspective Toward Prescription Opioid Abuse and Misuse: Summary of Findings. Available at: http://www.painfoundation.org/media/resources/physician-survey-summary.pdf.
American Pain Foundation. Overview of American pain surveys: 2005-2006. J Pain Palliat Care Pharmacother. 2008;22:33-38.
Shavers V, Bakos A, Sheppard V. Race, ethnicity and pain among the U.S. adult population. J Health Care Poor Underserved. 2010;21:177-220.