Multidisciplinary approach to pain management reduces reliance on opioids

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Integrated, multidisciplinary programs that help patients manage chronic pain through a range of therapy options could help stem the opioid epidemic, according to an article on philly.com, but getting insurers to cover these programs can be tricky.

The Philadelphia Veterans’ Administration (VA) has expanded the range of programs available to its pain patients to include physical, occupational and behavioral therapy, as well as a suite of alternatives to pain medication such as acupuncture, weight-loss management and meditation, among others. The article notes that similar pain clinics proliferated throughout the medical system in the 1990s, but the trend died out due to poor insurance reimbursement.

The VA has resuscitated the idea, running 67 “pain schools” across the United States, per previous reporting by FiercePracticeManagement. For patients outside the VA system, however, pain experts remain concerned about insurance companies’ reluctance to cover these types of therapies, even as the experts shift away from traditional views about pain management.

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New thinking among doctors who specialize in pain management suggests chronic pain may not be something medicine can target and cure with medications. Instead, doctors are seeing and treating chronic pain more as a condition in need of management, in part because it can be exacerbated by behavioral and emotional conditions, according to Martin Cheatle, a pain psychologist at Penn Medicine.

The complicated nature of chronic pain demands individualized treatment that takes into account physical and psychological elements of a patient’s condition, but the article points out that evidence supporting the effectiveness of specific treatments remains scarce due to a lack of research in the area. In the meantime, doctors continue to see medications as a necessary component of pain management for many patients, though many have looked to reduce their reliance on opioids, according to the article.

In interviews with philly.com, patients in the VA program reported both a decreased reliance on opioids and an improvement in their pain.

- see the article

 

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