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IHS Supports Patients in Pain Management

by Capt. Cynthia Gunderson, Chair of the IHS National Committee on Heroin, Opioids, and Pain Efforts

September is Pain Awareness Month. This is a time to raise awareness about pain and the role of individualized, multidisciplinary, and multimodal approaches to pain management. There are 50 million Americans living with chronic pain. It is important to remember that pain is a natural response that protects a person from harm and indicates a problem that needs attention; the pain experience is individualized and each person’s perception of pain is different; and living with chronic pain can impact daily function and in some cases be debilitating. Managing chronic pain is a journey. A journey that can begin as minor pain or severe pain, and some days there may be no pain. If managed appropriately, there can be successes.

Each person with chronic pain has a unique and personal path. For me—I have had chronic headaches that started due to a brain tumor as a young person. I’ve had years of doctoring, numerous MRI scans, denials, frustrations, fears, and admittedly a few days curled up like a baby on the floor wondering if I could ever feel ‘normal’ again, oftentimes forgetting what normal is. I decided last fall to work with my care team so I reached out to my provider to ask for help. I accepted a referral to physical therapy and participated in my care planning and goal setting as part of my treatment plan. A year later, I am experiencing fewer headaches and am able to function better in my day-to-day activities. I recognize that my story is one of 50 million and that I am truly fortunate in many regards.

As a pharmacist in the Indian Health Service, I am typically the last health care provider a patient sees on their visit to the clinic because the nature of pharmacy centers around medication management services, which occurs after a patient sees their provider. As a member of the care team, pharmacists work with patients to support individualized care plans, develop meaningful functional goals, coordinate treatment plans, and at times play a key patient advocacy role.

Across the Indian Health Service, the approach to pain management is shifting. Staff are completing additional training to support delivery of trauma responsive services and evidence-based strategies that apply knowledge to monitor patients for benefits and harms and modify treatment based upon clinical outcomes. Clinicians are collaborating with patients and families to respect patient autonomy and focus on functional care goals that are meaningful to the patient. The strategies improve patient outcomes and reduce risks. Health-systems are creating medical home models and interdisciplinary team-based care practices that support complex care delivery that improves patient outcomes. Providers and leadership staff are completing training on implicit attitudes and biases to support compassion and empathy in interactions throughout the system to meet patients ‘where they are.’ Implementation of these improvement strategies can be tracked and benchmarked in dashboards to support enhanced opioid stewardship activities that improve patient safety and outcomes.

During this month, let us each take a moment to make a commitment to self-reflection and recognize our role in promoting safe and supportive interactions that enhance patient and support community wellness.

Related Content:

Capt. Cynthia Gunderson, Chair of the IHS National Committee on Heroin, Opioids, and Pain Efforts

Capt. Cynthia (Cindy) Gunderson is the chair of the IHS National Committee on Heroin, Opioids, and Pain Efforts. In this role, she works alongside an interdisciplinary team to promote effective pain management, reduce overdose deaths, and improve access to culturally appropriate treatment.