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As America continues to invest in reducing their use and dependence on opioids, guidance released by the US Department of Health and Human Services in May of 2019 recommends a larger patient-centric, multidisciplinary approach to pain management. If you are a patient or a prescriber and asking yourself what does that mean, I’m glad you're reading this! In my role as COO at Pilleve I get the opportunity to visit a wide variety of practices and patients treating pain. While I am encouraged by the level of understanding and adoption I have seen of these guidelines, I have also uncovered some stubbornness and reluctance to change.
So what is a patient-centric, multidisciplinary approach to pain management? Simply stated, the guidance is challenging clinicians to craft personalized solutions with each individual patient, which makes sense as each patient and situation tends to be unique. The committee goes on to outline five separate approaches to consider when formulating individualized patient solutions including restorative therapies, interventional procedures, behavioral health approaches, complementary & integrative health solutions and opioid and non-opioid medications. Each of these are large concepts to cover on their own but a key takeaway here is medication regimes should be just one of a few approaches to treating pain.
From a medication perspective opioids usually get all of the press and attention. However, leaders in the field of pain management have identified non opioid medications to address certain types of pain in certain types of patients after diligent risk benefit analysis. These have included acetaminophen, non steroidal anti inflammatories (NSAIDs), anticonvulsants, antidepressants, musculoskeletal agents, anxiolytics. Again, these are larger concepts to cover in depth but a key takeaway here is if you are on a single medication for pain relief, and it is an opioid there might be an opportunity to improve your pain relief while reducing your opioid utilization and associated side effects.
If your current approach to pain management does not include these concepts, you might be overlooking options that could potentially benefit your patients and practice. If your current treatment feels a bit one dimensional and you don’t have a solid reason why, this should give you pause for thought. You might be overlooking ways to improve your quality of life! Take a moment and invest in the patient / physician relationship regardless of what side you are on. If you don't, who will?
Take care and goodbye for now,
Collin O’Neill, MBA, RPh, BCNP
U.S. Department of Health and Human Services. Pain Management Best Practices Inter-Agency Task Force report: updates, gaps, inconsistencies, and recommendations. May 9, 2019