NEW YORK (Reuters Health)—People with persistent pain need better access to psychosocial care, according to a position statement from the Society of Behavioral Medicine (SBM).
“Psychosocial approaches to pain management need to be available for all individuals with persistent pain in all healthcare settings,” Dr. E. Amy Janke from the University of the Sciences, in Philadelphia, told Reuters Health by email.
The U.S. government’s 2016 National Pain Strategy stresses the importance of comprehensive, interdisciplinary pain care. But despite convincing evidence supporting the efficacy of psychosocial approaches, these interventions are inaccessible to most Americans with persistent pain, Dr. Janke and colleagues on the SBM Health Policy Committee note.
The authors offer 10 policy recommendations for improving access to psychosocial care in a report online January 27 in Translational Behavioral Medicine.
Healthcare systems should support access to psychosocial pain care, remove system-related barriers that impede effective psychosocial care provision, ensure that providers who have competence in psychosocial pain care are available in settings where patients with persistent pain are regularly managed, and provide tools that support referral to psychosocial pain-care specialists.
For their part, healthcare payers should reimburse evidence-based psychosocial approaches in the care of persistent pain and reimburse according to a disease-management rather than fee-for-service approach, the authors say.
They also note that professional, education and training organizations should play their part by prioritizing training of pain providers, participating in the interprofessional education of healthcare providers in psychosocial pain care, integrating pain education at all levels of training and formally recognizing “pain psychology” as a specialty.
The committee also recommends that researchers “examine implementation models of psychosocial pain care across healthcare settings to determine best practices and improve dissemination of evidence-based model delivery systems.”
“While there’s overall agreement about the benefits of an interdisciplinary approach to pain care as outlined in the National Pain Strategy and the importance of psychosocial pain care generally, reimbursement structures and hospital systems aren’t designed to support such care,” Dr. Janke said. “Physicians don’t feel they have the time or training to provide the kind of care patients with pain need.”
“So, the controversy is that the disconnect between policy and guideline recommendations doesn’t allow providers to offer optimal care – guidelines underscore one thing, policy supports another, and physicians and patients are caught in the middle,” she said.
“The pain and opioid crises are related, and multiple points of system failure contribute to both,” Dr. Janke said. “The result is needless suffering. Feasibility of evidence-based recommendations to improve patient care and patient outcomes will be limited until policies are in place that actually promote this care.”