Chronic Pain Management and Nurse Practitioners - Essay Example

Chronic Pain Management and Nurse Practitioners This discussion explores chronic pain as an emerging issue in the deliveryof primary care. The number of people suffering from chronic pain continues to increase as years go by. The health people 2020 initiative seeks to reduce the number of people suffering from chronic pain and ensure adequate medication. Barriers to chronic pain management include the reimbursement policies, insufficient training on the part of nurse practitioners on how to handle new and coexisting chronic pain patients. In order to reduce chronic pain challenges, it is essential for curriculum developers to ensure that nurse practitioners students receive up-to-date training. Additionally, a revision of federal laws is needed to ensure that payers reimburse chronic pain sufferers with prolonged hospital visits. Introduction Delivery of healthcare is indispensably related to situations that call for intervention of pain relief. Nevertheless, pain is usually undertreated in many systems of healthcare delivery. This is an emerging issue in global health care delivery. This emerging trend of chronic pain highlights an issue that cannot be ignored, which is the failure of the health system to offer effective pain care and management to those who require it. It also highlights a fundamental issue on the role that nurse practitioners play in offering tailored care to people suffering from chronic pain (Banks & MacKrodt, 2006). Contemplation of the issue of effective pain management and the role of nurses in pain management serves to highlight the nursing profession is yet to advance a vigorous response to the problem of insufficient pain management both at the national and the international level (Johnstone, 2013). Lazarus & Downing, (2003) define pain management as the methodical study of medical and basic science and its application for the reduction of pain and suffering. Pain management also refers to the combination of tools and techniques taken from the distinctive healing art disciplines as a holistic application for the reduction of pain and suffering. Johnstone (2013) asserts that pain management is an emerging discipline stressing on interdisciplinary approach with the objective of reducing of pain and suffering. It is for that reason that this discussion focuses on the emerging trend of pain management, problems associated with pain management and the role of the nursing practitioners. Barriers in the treatment of chronic pain The Nurse Practioner Healthcare Foundation (2010) highlighted that acute pain is a universal phenomenon that is deemed as part of birth, life and death. Acute pain serves as a protective gear against injuries and illnesses. Chronic pain does not serve a known purpose and is currently viewed as a disease state by health practitioners. A research carried out in United States of America in 2006 indicated that approximately 76 million people in the country live with chronic pain. Approximately half of people suffering from chronic pain receive no treatment. Chronic pain results in financial burden to sufferers and also lowers their quality of life. The statistics revealed that chronic pain sufferers experience rejection, stigma and demeaning, which are undesirable social effects (Nurse Practioner Healthcare Foundation, 2010). The financial impact of chronic pain Chronic pain poses an intricate economic burden to the sufferers, their family, finance providers and the society at large. Limitations on third party re-imbursement practices have been implicated in matters of inadequate pain management. A study carried out by the American national institute of health in 1998 indicated that the direct annual expenses for treating chronic pain were approximately $100 billion. The study also forecasted the cost of treating chronic pain for the next 22 years in line with the 2020 healthy people initiative. The healthcare is anticipated to increase by 9 percent for all the 22 years since then. Indirect costs such as workplace absenteeism, disability, reduced productivity and replacement costs are anticipated to be more than the direct cost of treating chronic pain (Nurse Practioner Healthcare Foundation, 2010). According to the Nurse Practioner Healthcare Foundation (2010), other costs associated with chronic pain management are the diversion, abuse and misuse of Opioids prescription. These costs are anticipated to be approximately $1 billion per annum. Additionally, private and public insurance costs are projected to be $ 72.5 billion per annum as a result of diversion and abuse of controlled prescription drugs. The healthy people 2020 initiative seeks to bring the health economics and costs down by finding a balance between provisions of Opioids to appropriate candidates with chronic pain. The initiative also seeks to keep Opioids away from the hands of people who divert, abuse and misuse them (Nurse Practioner Healthcare Foundation, 2010). Lack of adequate education in pain management on the part of nurse practitioners As the primary caregivers, many nurse practitioners do not get adequate or up-to-date information with regard to assessment, treatment and monitoring of chronic pain. Nurse educators focus more on medical school education and less attention is given to residency training in chronic management. Health care practitioner students have not been suitably prepared to identify and treat patients with coexisting chronic pain (Nurse Practioner Healthcare Foundation, 2010). Given that basic professional education on chronic pain is scanty, it is no doubt that nurses practitioners tactics of proper prescription, giving out, overseeing and monitoring of long term opioids is even scantier. Ineffective systems and state policies to support chronic pain interventions Some of the systems employed to categorize and treat chronic pain hinder appropriate chronic pain management. For illustration, third party payment structures are centered toward repayment for acute therapy for chronic pain. An insurance company may not pay for simple chronic pain management, but may pay for opioids even at high doses. The Nurse Practioner Healthcare Foundation, (2010) notes that the Foods and Drugs Administration does not recognize chronic pain as a diagnosis and its treatment is viewed as off-label and thus not refunded by numerous payers. Another barrier to inadequate chronic pain management is the low prioritization of pain management. For illustration, there are little written standards and procedures for pain evaluation and management (Lazarus, & Downing, 2003). Legislative authorization at state and federal levels for governing controlled substances plays a significant role in chronic pain management. A challenge persists in terms of obtaining a balance between allowing for effective pain intervention, whilst enforcing laws formulated to counter illegal prescribing practices. Other barriers include lack of accountability for pain management and healthcare provider attitudes about the link between pain and illness that pain is a component of illness that ought to be eliminated (Lazarus & Downing, 2003). Recommendations As a result of the high prevalence of chronic pain and the contemporary alarming trends on abuse and misuse of opioids, curriculum developers must incorporate up-to-date topics such as chronic pain management in the syllabus. Since chronic pain is not recognized as a diagnosis, payers and other health players do not give it significant attention. In order to deal with the alarming rate, it is essential for the federal authorities to ensure coordination and provision of resources to solve chronic pain problems. This coordination and resources allocation should be based on the priorities of the healthy people 2020 initiative. Finally, the state and federal authorities should evaluate the current reimbursement policies in order to increase repayment for patients suffering from chronic pain who have extended hospital visits. References Banks, C. & MacKrodt, K. ( 2006). Chronic Pain Management. New Jersey: John Wiley & Sons press. Johnstone, J.M. (2013). Chronic pain management: a basic human right. Australian nursing journal 20, 6: 1-2. Lazarus, J.B., & Downing, B. (2003). Monitoring and investigating certified registered nurse practioners in pain management. Journal of law & ethics, 31, 1: 101-118. Moore A, et al. (2007). The social consequences for older people for neuropathic pain: a qualitative study. Pain Med. 8,3: 263-270. Nurse Practioner Healthcare Foundation. (2010). Managing chronic pain with opioids: a call for change. A white paper issued on 15 December 2010. Read More