For the more than 116 million Americans who experience pain, the medical costs and the economic costs related to disability days and lost wages and productivity amount to at least $560 billion to $635 billion annually, says a new report from the Institute of Medicine (IOM) that recommends the National Institutes of Health (NIH) designate a lead institute to move pain research forward and increase the scope and resources of its existing Pain Consortium.
Health care providers, insurers, and the public need to understand that although pain is universal, it is experienced uniquely by each person, and care must be tailored to each individual, say the report's authors. Successful treatment, management, and prevention of pain require an integrated approach that responds to all the factors that influence pain. The majority of care and management should take place through primary care providers and patient self-management with specialty care services reserved for more complex cases. Health care organizations should take the lead in developing innovative approaches and materials to coach and empower patients in self-management.
The report calls on Medicare, Medicaid, workers' compensation programs, and private health plans to find ways to cover interdisciplinary pain care. Individualized care, says IOM, requires adequate time to counsel patients and families, consultation with multiple providers, and often more than 1 form of therapy, but current reimbursement systems are not designed to efficiently pay for this kind of approach, and health care organizations are not set up for integrated patient management.
IOM also recommends that education programs for health care professionals include pain education in their curricula and promote interdisciplinary learning, and that licensing and certification exams include assessment of pain-related knowledge and capabilities.
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