Abstract ID: 3384

Primary Topic: State of the science/evidence base for integrative modalities
Secondary Topic: Interprofessional education

Evidence-based nonpharmacologic pain medicine as culture change in practice, education and policy: how do we get there from here?
Heather Tick, MD; Arya Nielsen, PhD; Samantha Simmons, MPH; Rosanne Sheinberg, MD; Rebecca Schultz, MS, , Milwaukee, WI, United States

Late Breaker: No

Overview

Medical pain management is in crisis. The U.S. leads in the epidemic of opioid overuse, abuse, addiction and death but the failure to adequately treat pain and the adverse effects of conventional pain treatments are a worldwide challenge. The National Academy of Medicine (NAM, formerly IOM), National Institutes of Health (NIH) National Pain Strategy, Veterans Health Administration (VHA), Department of Defense (DoD), the Federal Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), National Institute for Drug Abuse (NIDA), and the Joint Commission (TJC) have all called for increased use of evidence-based nonpharmacologic care. Moreover, these effective and low risk strategies should be engaged early in the course of care instead of as a last resort when all else has failed. The ACIMH is well positioned to present the evidence base for nonpharmacologic options, outline best practices, facilitate the development of teaching curricula and inform policy decisions to create a culture change in pain medicine and ultimately health care.

Rationale

  • Why the topic is important and its relevance to the conference themes? It is widely acknowledged that medical pain management is in crisis: from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths, the rising costs of pain care and managing adverse effects of that care has prompted action from state and federal agencies. The Consortium Pain Initiative was developed to address (inform) these issues with our unique combination of foundations in research, academic rigor, educational access, history of work with policy and our mission to shift health care to be more person centered, effective, evidence-based and safe.

Objectives

1) Discuss evidence-based nonpharmacologic strategies that are opioid sparing, have been shown to reduce opioid need.

2) Describe which nonpharm therapies have been shown to be effective for acute post surgical or trauma pain.

3) Describe which nonpharmacologic therapies have been shown to be effective for chronic pain, not only reducing the risk of opioid use but the illness behavior opioids produce.

4) Understand current state and federal policies facilitating and inhibiting implementation and integration of nonpharm therapies for pain

Methods/Session Format

Each speaker will have 15 min to discuss their topic as listed. Followed by audience participation conversation.

Outline

The Pain Project White Paper: introduction and the meaning of culture change in pain medicine. Thomas Kuhn outlined the steps that lead to culture change or paradigm shifts in science. Early adopters are significant catalysts in this process. This section will explore how work over nearly two decades has positioned the Consortium to help effect these changes. How do we build the road map for lasting culture change in medicine using the current crisis in pain medicine, the unsustainable costs of healthcare and the growing burden of disease as catalysts for change? (Heather Tick)

Evidence: the White Paper (Arya Nielsen)

  1. The Consortium Pain Task Force White Paper: Evidence-based Nonpharmacologic Strategies for Comprehensive Pain Care  
  2. Creating facile access to updates in evidence-based pain medicine.
  3. Dissemination strategies: learn to 'recruit and represent' for a culture change in medicine by relying on evidence-informed best practice
  4. Prepare for discourse and interview strategies when interacting with friendly, unfriendly, uinformed or hostile questions.

Clinical Best Practice: The development of best practices in nonpharmacologic pain care (Rebecca Schultz)

  1. Create evidence-informed clincal practice recommenations for pain conditions
  2. Incorporate whole person assessments to determine recommendations
  3. Encourage shared decisions making and partnering with patients to create a comprehensive pain plan that inclused nonpharm options
  4. Collaborate interprofessionally to enhance clinical knowledge and patient outcomes
  5. Identify resources to support nonpharmacologic pain options

Education: The development of educational curricula for nonpharmacologic pain care (Rosanne Sheinberg)

  1. Audience we seek to educate
  2. Creation of level playing field
  3. Paradigm shift
  4. Widening the tool box
  5. Dissemination in educating target groups
  6. Content to be covered

Policy: How to effect policy shift: (Samantha Simmons)

  1. This part of the session will focus on what attendees can do to help drive policy changes in their states, highlight resources available to them to assist their efforts and describe how some states have been successful in implementing policies that aim to help patients with pain and reduce opioid dependence and misuse.