TY - JOUR
T1 - Pain management best practices from multispecialty organizations during the COVID-19 pandemic and public health crises
AU - Cohen, Steven P.
AU - Baber, Zafeer B.
AU - Buvanendran, Asokumar
AU - McLean, Brian C.
AU - Chen, Yian
AU - Michael Hooten, W.
AU - Laker, Scott R.
AU - Wasan, Ajay D.
AU - Kennedy, David J.
AU - Sandbrink, Friedhelm
AU - King, Scott A.
AU - Fowler, Ian M.
AU - Stojanovic, Milan P.
AU - Hayek, Salim M.
AU - Phillips, Christopher R.
N1 - Publisher Copyright:
© 2020 BioMed Central Ltd.. All rights reserved.
PY - 2020
Y1 - 2020
N2 - Background. It is nearly impossible to overestimate the burden of chronic pain, which is associated with enormous personal and socioeconomic costs. Chronic pain is the leading cause of disability in the world, is associated with multiple psychiatric comorbidities, and has been causally linked to the opioid crisis. Access to pain treatment has been called a fundamental human right by numerous organizations. The current COVID-19 pandemic has strained medical resources, creating a dilemma for physicians charged with the responsibility to limit spread of the contagion and to treat the patients they are entrusted to care for. Methods. To address these issues, an expert panel was convened that included pain management experts from the military, Veterans Health Administration, and academia. Endorsement from stakeholder societies was sought upon completion of the document within a one-week period. Results. In these guidelines, we provide a framework for pain practitioners and institutions to balance the often-conflicting goals of risk mitigation for health care providers, risk mitigation for patients, conservation of resources, and access to pain management services. Specific issues discussed include general and intervention-specific risk mitigation, patient flow issues and staffing plans, telemedicine options, triaging recommendations, strategies to reduce psychological sequelae in health care providers, and resource utilization. Conclusions. The COVID-19 public health crisis has strained health care systems, creating a conundrum for patients, pain medicine practitioners, hospital leaders, and regulatory officials. Although this document provides a framework for pain management services, systems-wide and individual decisions must take into account clinical considerations, regional health conditions, government and hospital directives, resource availability, and the welfare of health care providers.
AB - Background. It is nearly impossible to overestimate the burden of chronic pain, which is associated with enormous personal and socioeconomic costs. Chronic pain is the leading cause of disability in the world, is associated with multiple psychiatric comorbidities, and has been causally linked to the opioid crisis. Access to pain treatment has been called a fundamental human right by numerous organizations. The current COVID-19 pandemic has strained medical resources, creating a dilemma for physicians charged with the responsibility to limit spread of the contagion and to treat the patients they are entrusted to care for. Methods. To address these issues, an expert panel was convened that included pain management experts from the military, Veterans Health Administration, and academia. Endorsement from stakeholder societies was sought upon completion of the document within a one-week period. Results. In these guidelines, we provide a framework for pain practitioners and institutions to balance the often-conflicting goals of risk mitigation for health care providers, risk mitigation for patients, conservation of resources, and access to pain management services. Specific issues discussed include general and intervention-specific risk mitigation, patient flow issues and staffing plans, telemedicine options, triaging recommendations, strategies to reduce psychological sequelae in health care providers, and resource utilization. Conclusions. The COVID-19 public health crisis has strained health care systems, creating a conundrum for patients, pain medicine practitioners, hospital leaders, and regulatory officials. Although this document provides a framework for pain management services, systems-wide and individual decisions must take into account clinical considerations, regional health conditions, government and hospital directives, resource availability, and the welfare of health care providers.
KW - COVID-19
KW - Pain Management
KW - Pandemic
KW - Public Health Crisis
KW - SARS-CoV-2
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U2 - 10.1093/pm/pnaa127
DO - 10.1093/pm/pnaa127
M3 - Article
C2 - 32259247
AN - SCOPUS:85083261581
SN - 1526-2375
VL - 21
SP - 1331
EP - 1346
JO - Pain Medicine (United States)
JF - Pain Medicine (United States)
IS - 7
ER -