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Home > HIN Case Studies
Relieving the Costs and Consequences of Chronic Pain: A Best Practice Multimodal Approach
Relieving the Costs and Consequences of Chronic Pain:  A Best Practice Multimodal Approach
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The financial, physical and emotional toll of pain on the United States is excruciating, but "Relieving the Costs and Consequences of Chronic Pain: A Best Practice Multimodal Approach" offers an antidote for the 25 percent of Americans suffering daily from chronic or persistent pain and the healthcare organizations that treat them. Featuring contributions from two of pain management's foremost experts, this special report offers multi-faceted strategies in pain assessment and management to improve quality of life for the chronic pain patient, reducing healthcare utilization in the process.

In this 35-page report, Marilee I. Donovan, Ph.D., R.N., regional pain management coordinator, Kaiser Permanente Northwest, and Cheryl Pacella, D.N.P., R.N., performance improvement advisor at MassPro, describe patient-centric pain management tactics that engage the patient as an active partner and employ creative and alternative therapies and interventions.

Rooted in best practices in pain management that avoid a cookie cutter approach, Donovan's and Pacella's programs seek to remedy these painful truths:

  • The American Pain Foundation in 2007 found that there were more patients with pain who needed treatment than with cancer plus heart disease plus stroke plus diabetes;
  • Low back pain is the leading cause of disability for Americans under the age of 45;
  • In 2004, $2.6 billion was spent on over-the-counter pain medications and $14 billion on outpatient analgesics;
  • Two recent surveys indicate that less than two hours is spent on pain management in most medical school curriculum and that most residents come out of medical school believing that 80 percent of patients are addicts and just seeking drugs.

Throughout "Relieving the Costs and Consequences of Chronic Pain: A Best Practice Multimodal Approach," Donovan and Pacella describe the components of their pain management programs, including:

  • Recasting chronic pain as persistent pain;
  • Using scales, ladders, totems and other pain classification tools;
  • Addressing pain medication side effects and addictions;
  • Applying cognitive behavior therapy in pain management;
  • Developing a patient-centered partnership in pain management;
  • Building a pain management foundation in primary care with a focus on patient and provider education;
  • Utilizing pharmacologic interventions and alternative therapies for pain management;
  • Understanding the needs of the elderly chronic pain sufferer;
  • Analyzing the impact of individualized pain management on healthcare utilization and patient satisfaction;
and much more, including a summary of responses from more than 185 healthcare organizations to HIN's April 2008 e-survey on pain management initiatives at physician offices, hospitals, nursing homes and health plans.

Table of Contents

  • Managing the Persistent Pain Patient: Strategies to Improve Quality of Life and Reduce Excessive Healthcare Utilization
    • Components of a Comprehensive Pain Assessment
    • Consequences and Cost of Pain
    • Using Pain Scales to Rate Pain
    • WHO Approach to Pain
    • Dispelling Pain Myths
  • The Effect of Pain Management on Healthcare Utilization
    • Hub and Spoke Model
    • Pain Patients Must Have Active Roles
    • Establishing a Multi-Modal Approach
  • Fixing What Hurts: HIN Pain Management e-Survey
    • Identifying Pain Patients
    • Easing the Pain
    • Pain Management Successes
  • Q&A: Ask the Experts
    • Educating Primary Healthcare Providers
    • Acceptable Levels of Pain Reduction
    • Negative Consequences of Pain Undertreatment
    • Reimbursing for Complementary Alternative Services
    • Managing Side Effects
    • Assessing Readiness to Change
    • Opiod Side Effects
    • A Medical Home for Pain Management
    • Comparing New and Old Pain Scales
    • Alternatives to Opiate Treatments for the Elderly
    • Online Pain Management Resources
    • Medication Adherence
  • Glossary
  • For More Information
  • About the Presenters
Publication Date: September 2008
Number of Pages: 35
ISBN 10: 1-934647-44-6 (Print version); 1-934647-45-4 (PDF version)
ISBN 13: 978-1-934647-44-8 (Print version); 978-1-934647-45-5 (PDF version)
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