AUSTRALIA could become the first country to recognise chronic pain as a disease in its own right, giving sufferers greater credibility and access to more integrated services.Chronic pain, which affects one in five people and costs the economy about $34.4 billion a year, is the third-most expensive health problem in Australia but most sufferers were still seen as malingerers or drug seekers by general practitioners and busy emergency department staff, the pain specialist Michael Cousins said yesterday.Professor Cousins, the director of the Pain Management Research Institute at the University of Sydney and Royal North Shore Hospital, has led a national draft strategy to have pain management addressed as part of the Federal Government’s national health reforms.The strategy, now open for public consultation, calls for a national advertising campaign to destigmatise chronic pain, a Medicare item number allocated to better evaluate its prevalence and costs, and a new system in hospitals where pain is included as one of the vital signs assessed by nurses.“All patients in hospital should be asked what level of pain they are experiencing on a scale of 0 to 10,” Professor Cousins said.“We take a patient’s temperature to see if they have a fever, so we need to be asking them to rate their pain as well. That’s the only way we will know to treat it and see if it is improving.”The strategy also calls for standardised assessments, phone hotlines for sufferers and their carers and a centralised website with links to services, information and resources. It wants funding for consumer groups, an ombudsman for personal injury insurance and pain management included as a core skill in undergraduate and postgraduate courses for doctors, nurses and allied health workers.Management of chronic pain, where a sufferer experiences daily pain for three months or more, was “shockingly inadequate” because it was still seen as a symptom of another condition rather than a problem in itself, Professor Cousins said.Many pain management clinics in Australia now had waiting lists of up to three years, and GPs were often reticent to prescribe large amounts of opioids or use newer methods of pain relief such as channel blockers, leaving sufferers with little help, he said.“Pain is one of the biggest health issues in Australia today – every bit as big as cancer, AIDS and coronary heart disease. It affects a person physically, psychologically and environmentally; and destroys all aspects of individual and family activities.”The chairwoman of the National Health and Hospitals Reform Commission, Christine Bennett, said the “scale, impact and cost of chronic pain is so alarming that it warrants a co-ordinated, national approach to address this major health issue”.A final version of the strategy, the result of thousands of hours’ work by more than 70 specialists, will be presented at the National Pain Summit in March and could see reforms put in place by the end of next year.”Chronic pain is costing us billions but half those costs could be saved if a strategy like this was implemented. It’s almost a no-brainer,” Professor Cousins said.
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