Excerpt

The Department of Health and Human Services, National Institutes of Health, has requested that the IOM (Institute of Medicine) convene the ad hoc committee to address the current state of the science with respect to pain research, care, and education; and explore approaches to advance the field.

Specifically, the committee will

• Review and quantify the public health significance of pain, including the adequacy of assessment, diagnosis, treatment, and management of acute and chronic pain in the United States. This effort will take a comprehensive view of chronic pain as a biological, biobehavioral, and societal condition.
• Identify barriers to appropriate pain care and strategies to reduce such barriers, including exploring the importance of individualized approaches to diagnosis and treatment of pain.
• Identify demographic groups and special populations, including older adults, individuals with co-morbidities, and cognitive impairment, that may be disparately undertreated for pain, and discuss related research needs, barriers particularly associated with these demographic groups, and opportunities to reduce such barriers.
• Identify and discuss what scientific tools and technologies are available, what strategies can be employed to enhance training of pain researchers, and what interdisciplinary research approaches will be necessary in the short and long term to advance basic, translational, and clinical pain research and improve the assessment, diagnosis, treatment, and management of pain.
• Discuss opportunities for public–private partnerships in the support and conduct of pain research, care, and education.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON ADVANCING PAIN RESEARCH, CARE, AND EDUCATION
• Reviewers
• Preface
• Acknowledgments
• Summary
  • CHARGE TO THE COMMITTEE AND STUDY APPROACH
  • THE NEED FOR A CULTURAL TRANSFORMATION IN THE WAY PAIN IS VIEWED AND TREATED
  • FINDINGS AND RECOMMENDATIONS
  • CONCLUSION
• 1. Introduction
  • STUDY CONTEXT AND CHARGE TO THE COMMITTEE
  • STUDY APPROACH AND UNDERLYING PRINCIPLES
  • WHAT IS PAIN?
  • WHO IS AT RISK?
  • IMPACT OF PAIN ON PHYSICAL AND MENTAL HEALTH
  • A TYPOLOGY OF PAIN
  • WHAT CAUSES PAIN, AND WHY DOES IT SOMETIMES PERSIST?
  • THE NEED FOR A CULTURAL TRANSFORMATION
  • ORGANIZATION OF THE REPORT
  • REFERENCES
• 2. Pain as a Public Health Challenge
  • SCOPE OF THE PROBLEM
  • DISPARITIES IN PREVALENCE AND CARE IN SELECTED POPULATIONS
  • THE SERIOUSNESS OF PAIN
  • THE COSTS OF PAIN AND ITS TREATMENT
  • POTENTIAL ROLES FOR PUBLIC HEALTH
  • FINDINGS AND RECOMMENDATIONS
  • REFERENCES
• 3. Care of People with Pain
  • TREATMENT OVERVIEW
  • TREATMENT MODALITIES
  • SELECTED ISSUES IN PAIN CARE PRACTICE
  • BARRIERS TO EFFECTIVE PAIN CARE
  • MODELS OF PAIN CARE
  • CONCLUSION
  • FINDINGS AND RECOMMENDATIONS
  • REFERENCES
• 4. Education Challenges
  • PATIENT EDUCATION
  • PUBLIC EDUCATION
  • PHYSICIAN EDUCATION
  • NURSE EDUCATION
  • OTHER HEALTH PROFESSIONS EDUCATION
  • CONCLUSION
  • FINDING AND RECOMMENDATIONS
  • REFERENCES
• 5. Research Challenges
  • EXPANDING BASIC KNOWLEDGE
  • MOVING FROM RESEARCH TO PRACTICE
  • IMPROVING AND DIVERSIFYING RESEARCH METHODS
  • BUILDING THE RESEARCH WORKFORCE
  • ORGANIZING RESEARCH EFFORTS
  • OBTAINING FEDERAL RESEARCH FUNDING
  • FOSTERING PUBLIC–PRIVATE PARTNERSHIPS
  • FINDINGS AND RECOMMENDATIONS
  • REFERENCES
  • ANNEX 5-1 MECHANISMS, MODELS, MEASUREMENT, AND MANAGEMENT IN PAIN RESEARCH FUNDING OPPORTUNITY ANNOUNCEMENT
• 6. A Blueprint for Transforming Pain Prevention, Care, Education, and Research
• Glossary
• APPENDIXES
  • Appendix A Data Sources and Methods
  • Appendix B Summary of Written Public Testimony
  • Appendix C The Economic Costs of Pain in the United States
  • Appendix D Committee and Staff Biographies

This study was supported by Contract No. N01-OD-4-2139, Task Order No. 234 between the National Academy of Sciences and U.S. Department of Health and Human Services, National Institutes of Health.

Suggested citation:

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

Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.