Addressing Obstacles to Evidence-Informed Pain Care

Abstract

Pain is a universal human experience and the most common reason patients seek health care. This article describes barriers to effective, high-quality, evidence-informed pain care. Based on the clinical literature and pain specialists' survey results, the AMA Pain Care Task Force suggests strategies that clinicians can use to offer good pain care to patients. The task force also canvasses key policy-level concerns that situate clinicians in micro-and macro-level complexities related to payers, workforce and training demands, legal and regulatory questions, research, stigma, and patients' beliefs and expectations. The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.

Implementation of Psychologically Informed Physical Therapy for Low Back Pain: Where Do We Stand, Where Do We Go?

“…Pain care in the United States has many improvements to make towards systematic implementation of effective, evidence-based, nonpharmacological treatments. 57 , 58 PiP delivered by physical therapists is one way to address this need, but while there is evidence to support its effectiveness for certain patient populations, evidence is lacking about the best way to implement these interventions into everyday clinical care. In this Perspective, we have presented a conceptual roadmap to move implementation of PIPT beyond the delivery of clinical trials and towards real-world adoption.…”

Dilemas bioéticos en la práctica clínica y el manejo del dolor crónico

“…El dolor es una de las causas más comunes por las que los pacientes buscan atención médica (18). El manejo del dolor plantea numerosos desafíos éticos (4,11,12,18,19,20).…”

“…El dolor es una de las causas más comunes por las que los pacientes buscan atención médica (18). El manejo del dolor plantea numerosos desafíos éticos (4,11,12,18,19,20). El dolor, en cualquiera de sus manifestaciones, pero sobre todo en situaciones críticas o de dolor no controlado, plantea dilemas éticos de recurrencia ineludible en los profesionales de la salud.…”

Multidisciplinary Firms and the Treatment of Chronic Pain: A Case Study of Low Back Pain

“…Expectations must be established and the poor results that are achieved with the existing market understood, further, all must accept that adequate pain relief, rather than total pain relief is the goal ( 71 ). Next, the group could determine the need and timing for certain therapies and limit the fairly common “fail first” model prior to granting authorization for some diagnostics and therapies when the model does not promote better care ( 72 ). Clinicians, researchers and economists must show the cost-benefit analysis of these programs for payers to desire them ( 73 – 75 ).…”