Interdisciplinary Chronic Pain Management Programs

The clinical literature has shown that no single health care specialty is able to meet the needs of the majority of patients who suffer from chronic pain. American society and government are increasingly asking that health professionals address the needs of patients and are placing more emphasis on the management of pain. However, they are also challenging us to document the effectiveness of our efforts and to provide care in a cost-effective manner. In 1979 the American Society of Anesthesiology developed a classification system of pain centers: the major comprehensive pain center, comprehensive pain center, syndrome-oriented pain center, and the modality-oriented pain center. Each type of pain center has different resources available to meet patient needs. Pain centers have been documented in some studies to provide effective management of chronic pain problems. However, many studies suffer from defects including limited patient information, a lack of control groups, the weaknesses of the pain measurement tools used, the lack of standardization of tools used, and small sample sizes. In spite of these weaknesses, it appears that interdisciplinary efforts to manage pain are succeeding in many patient groups. Multiple disciplines, including physician, psychology, pharmacy, nursing, and physical and occupational therapy must coordinate their efforts in an integrated fashion for optimal outcomes. Quality assurance should be an integral part of pain management, and follow-up to document effectiveness should be a part of this effort.