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Pain care and management for older Americans

The first issue of a new publication series from The Gerontological Society of America (GSA) called From Policy to Practice explores pain as a public health problem and takes a look at how various policies impact the care provided to patients in a range of practice settings. It also provides readers with an overview of provisions of the Affordable Care Act that address pain research, education, training, and clinical care – as well as steps taken to implement those provisions.

“An Interdisciplinary Look at the Potential of Policy to Improve the Health of an Aging America: Focus on Pain,” as this inaugural installment is titled, aims to ensure that researchers, practitioners, educators, and policy makers are aware of major policy issues at federal, state, and local levels that impact the prevention, assessment, and treatment of pain, as well as the social and practical supports required by older adults with pain. Support for the publication was provided by Purdue Pharma.

The issue was assembled by an expert panel chaired by GSA member Mary Beth Morrissey, PhD, MPH, JD, of Fordham University.

“This publication will serve as a resource for policy makers, researchers and practitioners dealing with the complexities of older adults’ pain experience in diverse social and cultural contexts,” Morrissey said. “It may also help to inform the design of broad-based policy and practice responses that encompass both medical and social services and supports.”

Joining Morrissey as faculty for the publication were GSA Fellows Ann L. Horga, PhD, or the University of Florida; Edward Alan Miller, PhD, MPA, of the University of Massachusetts, Boston; and Joshua M. Wiener, PhD, of RTI International.

“This publication addresses how public policy helps to shape responses by medical and long-term care providers to the needs of older people,” Wiener said. “My hope is that this publication will draw attention to the regulatory and funding constraints and incentives that currently exist and motivate changes to reduce pain among older people in the community, hospitals and nursing homes, especially at the end of life.”

Chronic pain affects about 100 million American adults – and costs the nation up to $635 billion each year in medical treatments and lost productivity, according to the 2011 Institute of Medicine (IOM) report “Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research,” which went on to identify older adults as a population at risk for inadequate assessment and treatment of pain.

Morrissey called the release of the new GSA publication very timely, as it follows on the heels of the recently released IOM report titled “Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life,” which recommends integrated financing of medical and social services for individuals with serious advanced illness.

“GSA’s primary focus in this 2014 report is bringing attention to the urgent needs of older adults living with pain, especially chronic pain that is often accompanied by multiple chronic illnesses,” Morrissey said. “These complex needs call for both person-centered and public health responses.”

The new issue of From Policy to Practice goes on to examine current policies in the context of the Affordable Care Act implementation and structural incentives for integrated and coordinated care, and highlight the role of policy in helping to eliminate pain disparities and assure equitable access to appropriate pain care and management for older Americans.

Morrissey additionally emphasized the value of the interdisciplinary approach taken by this publication.

“There is robust evidence showing that pain is a multidimensional experience involving the complex interaction of sensory, cognitive,emotional, social, cultural and spiritual dimensions,” she said. “In light of this, it is essential that knowledge and expertise from across the various disciplines – for example, medicine, nursing, social work, psychology, pharmacy, and rehabilitation therapy – be brought to bear on the challenges pain poses for older adults and their family caregivers through interprofessional and interdisciplinary collaboration.”

Source

The Gerontological Society of America