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Transforming Pain Care: An IOM Report

Pfeifer, Gail M. MA, RN, News Director

Section Editor(s): Pfeifer, Gail M. MA, RN

AJN, American Journal of Nursing: September 2011 - Volume 111 - Issue 9 - p 18
doi: 10.1097/01.NAJ.0000405050.15701.e2
In the News

Recommendations should be implemented by 2015, says panel.

Chronic pain affects at least 116 million Americans and may cost the United States as much as $635 million annually, according to a new Institute of Medicine (IOM) report, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. That cost alone is sobering in today's economic climate, but "chronic pain is a disease in its own right," according to Phillip A. Pizzo, who spoke at a June press briefing describing the IOM committee's findings. Pizzo is dean of the School of Medicine and a professor of pediatrics, microbiology, and immunology at Stanford University and chairman of the IOM committee that developed the report. The publication is meant to create an "action-oriented" road map, Pizzo explained, to addressing the shortfalls in U.S. pain assessment and treatment by outlining the specific problems and corresponding solutions.

The report includes a timeline calling for the implementation of the committee's four top recommendations by 2012 and all 16 recommendations by 2015. The top four recommendations constitute a population-level strategy for pain prevention, treatment, management, and research; reducing barriers to pain care; supporting collaboration among pain specialists and primary care clinicians; and establishing a new institute at the National Institutes of Health (NIH) that would be the "lead, accountable organization" promoting pain research and increasing support for and expanding the scope of the NIH Pain Consortium, said Pizzo.

An important element in transforming the way our health care system deals with pain is how clinicians are educated, said Margaret M. Heitkemper in a note to AJN. She is a professor and the chairwoman of the Department of Biobehavioral Nursing and Health Systems at the University of Washington, Seattle, and a member of the IOM committee.

"We need to make sure health care providers have the training and capacity to recognize patients' pain, provide management and care, and refer patients as needed to specialists," she said. "Pain is a unique experience, and pain care has to be tailored to the individual."

Pain resource nurse programs, discussed in the report, are one innovative model for educating nurse coaches and mentors who can promote best-practice pain strategies. The City of Hope National Medical Center in Duarte, California, developed such a program almost 20 years ago and has educated more than 2,000 nurses in pain management.

The full report and a Webcast of the panel discussion are available on the National Academies Press Web site at—Gail M. Pfeifer, MA, RN, news director

© 2011 Lippincott Williams & Wilkins, Inc.