Integrative medicine delivery models
Secondary Topic: Health Services Research/Cost Effectiveness
Changing the Pain Care Paradigm: Essential Actions for Moving Beyond Medications
Margaret A. Chesney, PhD; Leonard Wisneski, MD, , Denver, CO, United States; Robert Twillman, PhD, AIPM, Lawrence, KS, United States; Alison M. Whitehead, MPH, , Washington, DC, United States; David O’Bryon, JD, Academic Collaborative for Integrative Health, Bethesda, MD, United States
Late Breaker: No
New guidelines, regulations and legislation are nearly universal in recommending that first-line treatment for pain should focus on non-pharmacological treatments. Very few recognize the existing challenges inherent in following those recommendations. Many of these recommendations lack details about which treatments should be pursued for which patients. Other access challenges include, but are not limited to: inadequately educated providers, regarding how to optimally assess and refer people with pain; lack of central resources where professionals with non-pharmacological expertise can be identified as referral providers; a paucity of providers available in some, particularly rural, areas; and inadequate insurance coverage leaving people with pain paying out of pocket for care, something many find challenging.
This panel discussion, chaired by Margaret Chesney, Past Chair of the Consortium, will introduce these barriers and challenges to implementing the recommendations for non-pharmacological pain treatments and the pressing need to address them. Bob Twillman, Executive Director of the Academy of Integrative Pain Management, will discuss efforts aimed at helping providers assess patients with pain with an eye toward developing patient-centered care plans that include appropriate non-pharmacological treatments. David O’Bryon, Chair of the Academic Collaborative for Integrative Health, will follow with examples of professions, including acupuncture and chiropractic, which engage in educational and outreach efforts to clinical providers to convey the benefits of non-pharmacological treatments, a first step in developing referral resources. Alison Whitehead, the Consortium’s Policy Working Group’s Chairperson, will discuss the VA’s Patient-Centered Care and Cultural Transformation Program, and highlight lessons learned regarding incorporation of non-pharmacological treatments into that program. Finally, Len Wisneski, Chair of the Integrative Health Policy Consortium, will review the outcomes of the recent Pain Care Policy Forum, a meeting that involved professional organizations, pain patient advocacy organizations, and third-party payers, with a focus on improving insurance coverage for non-pharmacological treatments.
While the new guidelines calling for non-pharmacological approaches to pain are a major advance for integrative medicine and health, there are many challenges that need to be met in order for these strategies to be adopted widely into healthcare. It is important that these challenges be met before the current attention to this issue fades and new pharmacological approaches for pain management are introduced. The Consortium and other integrative health organizations are taking steps to communicate what is known about the evidence-base for integrative approaches. This panel discussion will focus on the critical next steps needed to translate that evidence in to action with a focus on education, access, and coverage.
Educational efforts need to be directed to both health care providers and the public about non-pharmacological treatment options, including the evidence base as well such details as expectations regarding frequency, dosing and shared responsibility.
Access in the context of this panel discussion will involve not only patients’ access to non-pharmacological care, but clinicians’ access to a resource or system to facilitate referring patients to experienced practitioners who can provide non-pharmacological pain care.
Coverage for non-pharmacological care is lacking despite the recommendations coming from the National Academy of Medicine, FDA, Joint Commission, and many other organizations. This panel discussion will present steps that are being taken to advance efforts to improve insurance coverage in today’s volatile heath care environment.
As a result of this panel discussion, attendees will: