APF offers actionable solutions to improve access to pain care

The American Pain Foundation (APF), the nation's largest consumer advocacy organization for people in pain, released today a position statement imploring the medical community, regulators and concerned stakeholders to reaffirm their ethical commitment to the 76.5 million Americans—or one in four people—who struggle with pain, work collaboratively to improve access to pain care and dismantle the barriers preventing timely, appropriate and effective pain care for millions.

Additionally, APF offered actionable solutions on how to improve access to pain care in the United States, which will reduce the physical, emotional and economic strain pain places on the individual, family and society in general.  Pain affects more people than diabetes, heart disease and cancer combined and costs an estimated $100 billion each year in medical claims, disability payments, lost wages and productivity.

"Alleviating pain has always been a basic principle of medicine and a moral obligation in a humane and civilized society," explained Will Rowe, CEO of APF.  "It is a travesty that in this day and age, pain remains woefully undertreated. The growing societal misconceptions and fears surrounding pain management that are only fueled by celebrity deaths along with unnecessarily restrictive regulation are creating mountainous barriers to access to care for millions of people in pain. The epidemic of untreated or undertreated pain must come to a halt."

According to the position statement, APF defines access to care as:

• Timely and appropriate pain care that includes access to the full range of legal, safe and effective treatment options for all individuals, regardless of race, ethnicity, gender, age, socioeconomic or insurance status, to lessen pain, promote recovery, restore function and improve quality of life.
• Individual comprehensive multimodal pain management plans devised by the person with pain and his/her health care team. Such plans will address complex factors, such as the patient's health status, clinical and social circumstances, pain condition, severity and functional impact of pain, patient preference, provider experience and availability.
• Use of multimodal treatment approaches tailored to the individual living with pain, including reasonable access to medically appropriate options such as pharmacotherapy, psychosocial intervention, physical rehabilitation, integration of complementary and alternative medicine (CAM), injection and infusion therapies, implantable devices and surgical intervention. Treatment options must include access to medications, including controlled substances, as necessary for an individual's pain treatment. Such medications should be used according to FDA-approved indications or other uses justified by research and clinical experience.

"The suffering and toll untreated pain has on our own families and our nation is irrefutable and will continue to skyrocket unless members of the medical community, regulators, legislators and nonprofit and private sector parties join forces to strategically conquer pain together," said Rowe.  "American Pain Foundation is reaching out to all stakeholders and asking for their commitment."

To improve access to pain care and remove the barriers that are preventing care, APF mandates the following actions:

• Educating the medical community and the public that chronic persistent pain is a disease state that requires medical attention and expertise. 
• Adapting disease management principles to guide primary care and appropriate specialty referral.
• Implementing standards and monitoring practices within all health care systems and ensuring that  transparency of pain care is an indicator in satisfaction surveys and other institutional quality ratings   (e.g., National Committee for Quality Assurance, Joint Commission on Accreditation of Healthcare Organizations).
• Developing and implementing state specific report cards on practice and access using the Pain & Policy Studies Group (www.painpolicy.wisc.edu) model for state policy report cards.
• Identifying and eliminating regulatory and third-party payer policies and medical practices that usurp  the "doctor-patient" relationship or deny pain care access to vulnerable groups or those policies that are primarily developed for cost savings that may supersede the best interest of patient care and  serve as an inappropriate and unacceptable form of health care rationing.
• Ensuring that reimbursement is compatible with the time required for effective pain assessment and  treatment and that it includes multi-disciplinary/multimodal practice of care.