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8 Articles in this Series
Introduction
AAPM's Advice for Evidence-Based Opioid Prescribing Guidelines
CBT for Chronic Pain and Insomnia Needs More Research
Farewell Opioid Therapy, Hello Mental and Behavioral Health
Ketamine’s Growing Use in Chronic Non-Cancer Pain Management
MR Neurography in CRPS Assessment
Navigating New Opioid Prescribing Requirements: Practical Legal Advice for PCPs & Pain Specialists
TACs: Identifying and Treating the Non-Migrainous Headache
Video: Dr. Aronoff on Shifts in Pain Care

Farewell Opioid Therapy, Hello Mental and Behavioral Health

As the pain management industry continues to seek effective, long-term alternatives to opioid therapy, the American Academy of Pain Medicine’s 34th annual meeting in Vancouver shed light on the growing respect for the role of behavioral and mental health care in multimodal pain medicine. Using the theme of “acceleration,” keynote speaker Amy L. Compton-Phillips, MD, said, “The world is changing rapidly,” and with it, “the transformation of medicine has begun.”

Two poster sessions at the 2018 meeting highlighted the accelerated search for opioid alternatives. The first study demonstrated that patients with chronic non-cancer pain may actually decrease how much they use the healthcare system by undergoing pain rehabilitation programs that address pain impact and daily functioning. Led by Christy Hunt, DO, MS, the retrospective study found statistically significant trends in this regard, noting that opioid reduction was a key outcome.

Pain rehabilitation programs, or PRPs, are often used among patients who are tapering from or discontinuing opioid therapy. By lowering opioid use and raising behavioral therapy participation at the same time, the analysis revealed that these patients reduced time spent with primary care and specialty healthcare providers. These findings may be of unique interest to hospitals as they release patients after surgery and recommend a forward-looking treatment path.

A related poster abstract revealed results of mental health’s growing role in multidisciplinary pain treatment. Care focused on function, mood and sleep may improve chronic pain, according to the researchers, based at the University of Pittsburgh’s Medical Center Pain Medicine clinical network.

At the Pittsburgh center, patients with chronic pain see a pain psychologist and a psychiatrist. After analyzing 15,000 records with PROMIS-based patient-reported outcomes, lead study author Ajay Wasan, MD, noted that while the psychological amplification of chronic pain and disability is well known, his team’s study “is the first to show…significant clinical benefits to embedding a psychologist in a pain specialty practice.”

Dr. Wasan noted that while the cost of bringing on a psychologist may be a deciding factor for pain clinic teams, the additional benefits are worth the full multimodal pain treatment outcomes for patients.

 

 

 

Next summary: Ketamine’s Growing Use in Chronic Non-Cancer Pain Management
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