Chronic Pain Management to Benefit the Beneficiary

Story Number: NNS120816-13Release Date: 8/16/2012 10:32:00 AM
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By Douglas H. Stutz, Naval Hospital Bremerton Public Affairs

BREMERTON, Wash. (NNS) -- Naval Hospital Bremerton hosted members of the Navy Comprehensive Pain Management Program (NCPMP) for a fact-finding, brain-storming collaboration visit Aug. 8 and 9.

According to Capt. Ivan Lesnik, Navy Medicine West NCPMP lead, the general objectives for this BUMED initiative program are to aid in the restoration of function and relief of pain by broadening access to evidence-based, standardized, multimodal, and interdisciplinary pain care across Navy Medicine, ensuring treatment efficacy through practice guidelines, education, and analysis of treatment outcomes.

"The Pain Management team was here to meet and gather information on program capabilities we have at NHB. We all want to know how to implement better methodology with our stakeholders in all of our departments and clinics to help our beneficiaries," said Cmdr. Brendan Melody, NHB director of Administration.

"There is a crisis in effectiveness in handling pain. The number one issue from beneficiaries and active duty personnel is about pain. Pain is the most common complaint. Its loss of function and it impacts quality of life. We have used the tools that we have but that's not enough," said Lesnik.

"Establishing a multidisciplinary approach within the Medical Home environment which is focused on improving the patient's quality of life while training the Medical Home Port team in the various modalities and approaches available is absolutely the right approach. The concept definitely aligns with the integrated and coordinated team care tenants inherent to patient-centered Medical Home. It will provide the Medical Home teams with multiple alternative treatment options for managing chronic pain in lieu of a purely pharmacological approach. Patients are inundated with advertisements depicting various medications to use in the treatment of pain, even though there are multiple other options available that can be as equally or more affective," said Cmdr. Patricia M. Taylor, NHB deputy director for Medical Services.

The Navy response to improve handling pain capabilities is based on the 2010 National Defense Authorization Act and 2011 Assistant Secretary of Defense for Health Affairs memorandum requiring standardized, comprehensive, multidisciplinary pain management in the Military Health System.

"This is really about pushing our care to the deck plates, especially improving access to care with a big emphasis on restoring function and capability. Anything that erodes readiness is a deterrent. The major pain areas continue to be the lower back, joint and shoulder pain for the junior and senior enlisted personnel," Lesnik said.

Lesnik said chronic pain is at a current state where it is a disease and economic burden to the entire country.

"From the utilization of care standpoint, the most common office visit complaint is chronic pain, which is directly associated with loss of function, quality of life and workdays. Chronic pain impairs readiness and is a common medical evacuation cause," said Lesnik.

Lesnik notec that special emphasis will be placed on improving quality of life and functionality, decreasing pain, increasing patient satisfaction, reducing pain-related costs, lessening limited-duty days, and improving access to care for complex acute, high-risk acute and chronic pain patients.

"The vision is readiness through restoration of function and relief of pain. Navy Medicine's solution at our military treatment facilities, hospitals and clinics is to have multidisciplinary pain care teams that we call R4 Pain teams. R4 is reference to readiness, restoration of function, relief of pain and research," Lesnik said, stating that the plan is to have R4 Pain Team and R4 Regional Subspecialty Support team assets available for providing a range of assistance for everything from direct clinical care to reviewing complex cases to embedding with specific specialty areas to help mitigate chronic pain.

"Chronic pain really is very patient-specific and requires a thorough assessment of the patient's physical and psycho-social elements to determine the best course of action. The multidisciplinary approach outlined in the Navy Comprehensive Pain Management Program will improve communication between the various disciplines involved in the patient's care and should improve patient participation and health outcomes," Taylor said.

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