TY  - CHAP
M1  - Book, Section
TI  - Multidisciplinary Care of Chronic Pain
A1  - Prasad, Ravi
A1  - Hah, Jennifer
A2  - Longnecker, David E.
A2  - Mackey, Sean C.
A2  - Newman, Mark F.
A2  - Sandberg, Warren S.
A2  - Zapol, Warren M.
PY  - 2017
T2  - Anesthesiology, 3e
AB  - KEY  POINTSAlthough  chronic  pain  affects  more  Americans  than  diabetes,  cancer,  and  heart  disease  combined,  its  exact  incidence  and  prevalence  is  difficult  to  determine  as  it  is  often  viewed  as  a  symptom  rather  than  as  a  discrete  diagnosis.Chronic  pain  is  an  expensive  problem:  in  the  United  States  alone,  it  is  associated  with  an  annual  cost  of  $560-$635  billion  in  lost  productivity  and  healthcare  expenses.A  purely  biomedical  approach  can  be  helpful  when  treating  acute  pain,  as  this  model’s  focus  on  pharmacologic,  interventional,  and  surgical  treatments  may  lead  to  complete  elimination  of  pain.  This  model  does  not  usually  result  in  long-term  amelioration  of  symptoms  in  individuals  suffering  from  chronic  pain  conditions  and  is  thus  not  as  efficacious  in  this  population.Many  chronic  pain  conditions  lack  a  clear  and  specific  pathophysiology  and  are  best  conceptualized  as  an  interplay  of  biological,  psychological,  and  social  factors.  Such  a  biopsychosocial  formulation  is  the  most  widely  accepted  approach  to  treating  and  managing  chronic  pain  conditions.Employing  a  biopsychosocial  approach  to  pain  evaluation  and  treatment  requires  use  of  clinicians  that  represent  a  range  of  different  specialty  areas  beyond  the  field  of  medicine.  Such  multidisciplinary  teams  work  collaboratively  with  patients  to  advance  their  care.A  pain  physician/physician  extender  is  usually  the  lead  clinician  on  a  multidisciplinary  treatment  team.  This  person’s  roles  include  completing  a  thorough  medical  workup,  optimizing  medications,  assessing  for  the  role  of  interventional  treatment,  and  coordinating  care  among  the  rest  of  the  treatment  team.A  pain  psychologist  identifies  the  role(s)  that  different  substances,  stressors,  emotional  states,  and  lifestyle  factors  have  on  the  experience  of  pain  and  works  with  patients  to  help  address  the  adverse  impact  they  can  have  on  treatment  outcomes.Physical  therapists  focus  on  all  aspects  of  patients’  physical  functioning  as  related  to  their  chronic  pain  condition.  These  clinicians  help  patients  engage  in  appropriate  exercises  that  target  specific  movement  impairments.  Their  work  often  improves  flexibility  and  strengthening  while  concurrently  reducing  inappropriate  guarding  and  fear  of  activity.Other  specialists  that  may  be  included  on  multidisciplinary  teams  include  other  medical  disciplines,  addictionologists,  pharmacists,  dietitians,  care  managers,  and  complementary  and  alternative  medicine  specialists.Multidisciplinary  treatment  approaches  for  chronic  pain  are  more  cost-effective  compared  to  purely  biomedical  models.  This  modality  of  treatment  is  associated  with  reduction  in  pain  intensity,  disability,  and  other  psychosocial  outcomes  and  is  often  used  to  facilitate  weaning  of  opioid  medication.Many  of  the  recommendations  made  in  the  National  Pain  Strategy’s  2016  report  can  be  facilitated  through  use  of  multidisciplinary  teams.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/20
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=1144137616
ER  -