Chronic Pain is a common condition that affects over 116 million U.S. adults at a cost of $560 to 635 billion annually. Evans Army Community Hospital is working to battle this problem by educating its staff during a Pain Stand Down Day, June 18.
The day included two 3-hour sessions led by guest lecturers for Evans healthcare teams, as well as providers from the Air Force Academy and Peterson Air Force Base.
"We are having the stand down to educate primary care providers on proper management of chronic pain," said Lt. Col. Jinjong Chung, Evans Primary Care Pain Integrator. "Besides the billions of dollars it costs each year in direct medical expenses and loss of productivity, there is a human cost for those suffering with chronic pain. They have decreased functionality and a sense of futility."
According to Chung, chronic pain suffers feel this way because the easiest way to treat them is to prescribe opioids.
"80 percent of patients will stop taking opioids after one dosage, because they don't like the way the medication makes them feel," said Dr. David Tauben, guest lecturer and chief of University Washington, Division of Pain Medicine. "So we have to find other ways to help them."
"At Evans we use multi-disciplinary teams -- clinical pharmacists, behavior health providers, and physical and occupational therapists -- to make sure that we are giving our patients the quality care they deserve," said Chung. "And these lectures are going to help our entire health care team."
According to Tauben, the training at the stand down day is needed because during the four years of medical school, only six hours are dedicated to pain management. Besides the guest speakers, Evans staff can also increase their pain management knowledge by taking the hospital's Advanced Pain Management Course.
The pain stand down lectures were presented by Tauben and another doctor from the University of Washington Pain Services and a pain consultant who works for the Army's Western Region Medical Command.
"Having outside experts speak gives us a different view point on the subject," said Chung. "And it lets us know what they are doing at the University of Washington, which is a on the leading edge of chronic pain management."
The main objectives of the lectures for the day were understanding public health issues, telemedicine for pain care and knowing when to get help and where to go for that help.
Tauben told the attendees that prior to the 1990 prescribing opioids to patients for chronic pain was taboo, but in the 1990s state laws were changed making it an acceptable practice.
To assist the doctors who are prescribe opioids today Dr. Diane Flynn, guest lecturer and the Primary Care Management Advisor for Western Region Medical Command, talked about two weekly telemedicine pain management sessions, one run by the University of Washington, the other by the military . These sessions are set up so that no matter where in the world a doctor is located they have a chance to "sit in" on a pain management discussion.
For the last part of the Pain Stand Down Day, the providers broke into small groups and were presented case studies of chronic pain patients. Patient particulars were given and the groups had to come up with recommendations for a pain management plan for the "patient".
One case study was a lady in her late 20s, with four children and on two different opioids to help with her chronic back pain. She wants to do things with her children but doesn't think she can function while on the opioids, but is barely able to move without them.
The overall consensus of the group was that she needs to be a big part of her treatment plan, because if she isn't on board she will resist and not carry through with it.
"When I have a patient who is on a "cocktail" (multiple) opioids I always ask them which one they can do without the most," said one Evans doctor. "And then we start to taper them off that one."
"The reason that we use a multi-disciplinary team is because we can't just take away someone's medication and not replace them with something else," said Chung.
For the case study it was suggested that the lady begin a low-impact exercise regime to help her strengthen her back -- walks with her kids or a yoga class. She could also attend the weekly Evans Pain School at the Fort Carson Army Wellness Center to learn about workable strategies to manage her pain.
With patients and providers working together Chung said the hope is to win the battle and cut down on the monetary and human cost of chronic pain.
The Evans Pain School is held every Thursday (except last Thursday of the month) at 1 and 2 p.m. at the Fort Carson Wellness Center (located on post across from the street from the Kentucky Fried Chicken). General and advanced topics include: Productive Partnerships, Coping with your Feelings, and Staying Safe with your Medications. No appointments are needed, walk-ins are accepted. For more information on the Pain School call 524-2619.
Related Links:
Evans Army Community Hospital Web Page
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