Library
APS Bulletin • Volume 17, Number 3, 2007
President’s Message
Judith Paice, PhD RN
Our Unique Perspective
The American Pain Society (APS) is a community of people who represent many disciplines and come together to address issues related to the basic science and clinical management of pain. This interdisciplinary nature is one of our core values and makes us unique among professional, scientifically based pain organizations. As a result of our unique perspective, APS has the responsibility and challenge of advocating for an interdisciplinary approach in all that we do.
There are many benefits of multiple disciplines working together including the rich perspectives that many views can bring to a discussion. There are also some obstacles: Our educational backgrounds vary, our disciplines each have a unique vocabulary, and we often function in isolation from our colleagues. APS provides several opportunities to assist members in overcoming these barriers through support of interdisciplinary care and education.
Interdisciplinary Pain Care
Unfortunately, there is no consensus about either the definition or essential attributes of interdisciplinary pain care. Minimally, it includes medical therapies, psychological treatment, and physical and/or occupational therapy. The best programs incorporate these strategies and pay attention to socioeconomic concerns, family interventions, education, and other rehabilitation services. Metaanalyses and systematic reviews of interdisciplinary pain care demonstrate that these programs provide better outcomes than no treatment or single discipline treatment (e.g., medication or psychological counseling alone) (Flor, Fydrich, & Turk, 1992; Gatchel & Okifuji, 2007; Guzman et al., 2001). In a review of interdisciplinary pain rehabilitation programs, Turk finds that these programs provide comparable reduction in pain when compared to standard pain treatment modalities (e.g., medications alone or surgery).
Although no treatment completely eliminates pain, interdisciplinary pain rehabilitation programs are associated with significantly better outcomes for medication use, healthcare utilization, functional activities, return to work, and closure of disability claims—all with substantially fewer adverse events (Turk & Swanson, 2007).
If these programs are superior, why are they closing at an alarming rate? The reduction in the number of these programs is due to a variety of factors, including the current U.S. system of healthcare reimbursement. Although we alone may not be able to change our current healthcare system, APS employs strategies to highlight interdisciplinary care and to foster interdisciplinary educational efforts.
CCOE Awards Program
The Clinical Centers of Excellence (CCOE) in Pain Management program highlights interdisciplinary programs that exemplify outstanding clinical care. It honors teams that provide appropriate access to interdisciplinary and multimodal care through the involvement of specialists from a variety of disciplines. By honoring these programs, APS sets a standard that other clinicians can emulate and that third-party payors can see as the most effective strategy for addressing pain. Click here to read more about the 2008 program and gala.
Annual Meeting
The annual scientific meeting provides an opportunity for many disciplines to interact and network with the intent of translating scientific discoveries from the bench to the bedside and back. The meeting is attended by a diverse group of pain scientists, clinicians, policy makers, and other professionals and affords them the opportunity to discuss results, debate the implications, and raise questions. Symposia speakers represent varied disciplines and present the most recent scientific findings. For example, a basic scientist might describe the underlying mechanisms of a unique pain syndrome, a clinician might describe the epidemiology or a metaanalysis of current pharmacological therapies, and a psychologist would discuss research findings related to cognitive-behavioral approaches in this population. Tim Brennan chairs the 2008 Scientific Program Committee and has convened a strong group of APS members who represent many disciplines and are developing an extraordinary meeting.
These are just a few examples of APS’s efforts to enhance interdisciplinary activities. Others include The Journal of Pain Case Reviews in Pain and evidence-based documents produced by the Clinical Practice Guidelines Committee. We welcome your suggestions as APS continues to promote interdisciplinary efforts—it is our unique contribution to the field of pain.
References
Flor, H., Fydrich, T., & Turk, D.C. (1992). Efficacy of multidisciplinary pain treatment centers: A metaanalytic review. Pain, 49, 221–230.
Gatchel, R.J., & Okifuji, A. (2006). Evidence-based scientific data documenting the treatment and cost-effectiveness of comprehensive pain programs for chronic nonmalignant pain. Journal of Pain, 7, 779–793.
Guzman, J., et al. (2001). Multidisciplinary rehabilitation for chronic low back pain: Systematic review. British Medical Journal, 322, 1511–1515.
Turk, D.C., Swanson, K. (2007). Efficacy and costeffectiveness of treatments for chronic pain: An analysis and evidence-based synthesis. In M. Schatman & A. Cooper (Eds.), Multidisciplinary Chronic Pain Management: A Guidebook for Program Development and Excellence of Treatment (pp. 15–38). New York: Informa Healthcare.
