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The country’s response to the national opioid crisis is evolving: President Trump announced that he will soon declare opioid abuse a national emergency; cities are lining up to sue pharmaceutical companies; and state attorneys general are pressing insurance companies to better support nondrug approaches to pain treatment.

Meanwhile, APTA has been bringing the physical therapy profession’s voice and perspective to the national dialogue on how best to reshape the health care system’s approach to pain treatment and management.

The association has been active in responding to opioid abuse since 2015, when APTA was invited to join a White House initiative under then-President Barack Obama. In 2016, APTA launched the #ChoosePT opioid awareness campaign, a high-visibility effort that was championed by individual members and state chapters, and received both state and national recognition.

So what’s APTA been up to since then? A lot.

We were at the table for the first-ever Integrative Pain Care Policy Congress.

Sponsored by the Academy of Integrative Pain Management (AIPM), this recent event brought together representatives from organizations including APTA, the American Pharmacists Society, the American Osteopathic Association, BeaconHealth, Kaiser Permanente, the National Association of Social Workers, the American Cancer Society, and Aetna for discussions and presentations on how to best address conflicting pain care guidelines.

APTA Director of Regulatory Affairs Kara Gainer, JD, represented the association, participating in a panel discussion on how to strengthen state-level policy on integrative pain management.

We’re helping to draft a national playbook on opioid prescribing and effective pain management.

The association is working with 40 other organizations as the Opioid Stewardship Action Team, a group assembled by the National Quality Forum (NQF), a health care research and advocacy group. APTA is a member of NQF.

According to NQF, the goal of the team is to work on “strategies and tactics to support appropriate opioid prescribing practices and more effective pain management, particularly for individuals with chronic pain and those at risk of dependence and addiction.” That work will result in a “playbook” in March 2018 that NQF hopes will help to establish a more cohesive approach to pain management. In addition to APTA, task force participants include representatives from the US Centers for Disease Control and Prevention (CDC), the American Nurses Association, Kaiser Permanente, the US Centers for Medicare and Medicaid Services, Magellan Health, the American Society of Health System Pharmacists, and the Substance Abuse and Mental Health Services Administration. Alice Bell, PT, DPT, an APTA senior payment specialist, is representing the association on the task force.

We’re keeping members in the loop, adding to evidence-based resources for pain management, and planning for next steps in advocacy.

Policy-based approaches to the opioid crisis were front-and-center at the most recent APTA State Policy and Payment Forum in September, which featured a presentation by representatives from the National Journal. APTA also is thinking about the future and is working through its Public Policy and Advocacy Committee to develop a roadmap for where the association can have the biggest impact on policy.

At the same time, APTA continues to add resources to put physical therapists in touch with the best evidence on pain assessment, treatment, and management through PTNow. The association is engaged in activities related to reviewing and developing CPGs, including reviewing CPGs related to opioid therapy for chronic pain from external groups and supporting the Education Section and Orthopaedic Section of APTA in the development of a CPG focusing on patient education and counseling for the management of chronic pain.

APTA members have been awarded federal research grants to study pain treatment.

The US Departments of Defense, Health and Human Services, and Veterans Affairs have created an interagency partnership that aims to focus on research related to nondrug approaches to pain treatment for military and veteran personnel. The partnership’s first order of business: providing grant awards to fund research projects. APTA members Julie Fritz, PT, PhD, FAPTA, and Steven George, PT, PhD, each were named as recipients in the first round of grants.

According to a press release from the partnership, Fritz will research a “stepped care” approach to the treatment of low back pain. George will conduct a planning and demonstration project to improve access to nondrug therapies for low back pain through the Department of Veteran’s Affairs health care system.

#ChoosePT continues to gain momentum.

The video supporting the #ChoosePT campaign is still making the rounds nationally, while, more recently, #ChoosePT ads are appearing on national news websites during October. Additionally, the campaign toolkit was updated with several new graphics and resources—including the opportunity to purchase #ChoosePT t shirts at cost.

The campaign also has advanced through the efforts of members. Most recently, APTA collaborated with student volunteers in New York to bring the #ChoosePT message to the Today Show in September and Good Morning America in October.

We’re reaching out to other stakeholders.

Over the past year, APTA staff and representatives have met with representatives from the Food and Drug Administration, the Department of Veterans Affairs, the Health Resources and Services Administration, CDC, and several other agencies and groups to discuss the importance of patient access to nondrug approaches to pain. Coming up: meetings with the Indian Health Service and the Administration for Community Living.

APTA President Sharon Dunn, PT, PhD, believes there’s good reason for the association’s multifaceted approach to the issue.

"We need to change the culture around pain management in this country—that’s going to require raising public awareness through efforts such as the #ChoosePT campaign, but it’s also important that individuals and organizations throughout the health care space are actively engaged in working to enhance understanding of safe and effective pain management through interdisciplinary care,” Dunn said. “It’s important that APTA and the physical therapy profession participate in these efforts because we bring a unique perspective to the conversation.”

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