Friday, August 12, 2011

Summary of IOM Report, Relieving Pain in America

Pain in America The 2010 Patient Protection and Affordable Care Act required the U.S. Department of Health and Human Services (HHS) to enlist the prestigious Institute of Medicine (IOM) in examining pain as a public health problem. The lengthy report, released on June 30, 2011 — Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research — calls for a cultural transformation of attitudes toward pain and its prevention and management. Here is a short summary of report highlights that interested readers can use to brief colleagues or organizations to which they belong that are interested in better pain care.

This report was previously discussed in more detail in a Pain-Topics UPDATE [here]. The summary below was developed by Robert J. Saner, principal at Powers Pyles Sutter & Verville PC in Washington, DC, and Jan Favero Chambers, president of the National Fibromyalgia & Chronic Pain Association (NFMCPA), along with input from various members of the U.S. Pain Care Forum.


On June 30, 2011, the Institute of Medicine’s blue ribbon Committee on Advancing Pain Research, Care, and Education issued what is unquestionably the most comprehensive report on pain in America ever produced. Its findings and recommendations are dramatic and unequivocal:

  • Pain represents a public health crisis of epidemic proportions;

  • There is a moral imperative to address this crisis; and

  • Solutions will require a cultural transformation in the way pain, particularly chronic pain, is understood, assessed and treated.

The IOM found the basic facts of chronic pain in America to be staggering:

  • 116,000,000 adults are burdened with it — that’s more than 1 in 3 adults, and more persons than are afflicted by heart disease, diabetes and cancer combined.

  • The prevalence of chronic pain will only increase as the population ages and as the effects of obesity manifest themselves in pain-related conditions like diabetes and musculoskeletal pain.

  • Chronic pain annually costs the American economy between $560-635 billion in added healthcare and lost productivity (excluding costs of pain affecting institutionalized individuals, military personnel, and children under age 18).

  • Public healthcare programs absorbed almost $100 billion in pain care costs in 2008.

  • Human suffering is often unnecessary — millions of people get inadequate pain relief for conditions that could be treated or managed.

The IOM recommends a comprehensive, population level strategy to address pain as a complex chronic disease, not just a symptom of other injury and illness, including:

  • Developing a comprehensive plan by HHS with specific goals, actions, and timeframes by the end of 2012;

  • Reducing barriers to access—whether legal, regulatory, reimbursement, or cultural;

  • Educating the public on prevention, treatment, and self-management;

  • Improving professional education across the spectrum of disciplines, and throughout the continuum of undergraduate, graduate, and continuing health professions training; and

  • Focusing pain research efforts at NIH, and coordinating that research with other government agencies and the private sector in order to speed the development of new therapies, foster interdisciplinary approaches, increase longitudinal research of people in pain, and increase the number of pain researchers.

From: IOM (Institute of Medicine) 2011. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research. Washington, DC; The National Academies Press. [Access document here.]