The NSW Pain Management Plan (2012-2016) has made a big difference to people’s lives, creating new services and efficiencies in the health system and transforming the understanding and treatment of chronic pain.
An evaluation conducted by HealthConsult, reveals that the state has significantly reduced wait times at public pain clinics to a mean of 63 days (from 18 months to 2 years), while demand for health services (GP, allied health, emergency department) from people who attend a pain clinic has decreased—relieving pressure on the health system.
Pain clinics are also making a difference to opioid usage, with a 36 percent reduction in patients using opioids for more than two days a week and a 42 percent reduction in average daily morphine equivalent dose for patients taking opioid medication. This contrasts with an increase across the state in the total supply of opioids and oral morphine equivalent per script.
Patients who attended a multidisciplinary pain clinic reported (from referral to episode end):
more periods without pain;
a reduction in the number of pain regions;
improvement in pain severity and less interference due to pain;
less depression, anxiety and stress;
improvement in employment and/or study status; and
improvement in function (higher PSEQ scores).
People are learning a range of techniques to self-manage their pain, with the majority using physical activity, complementary medicines, relaxation, meditation, physical therapy and/or finding help through support groups. Over-the-counter medication was used by just 10 percent of respondents.
Health professionals are becoming increasingly aware of chronic pain information, with more than 70 percent accessing professional development opportunities. They reported an improved understanding of multidisciplinary teams and how to incorporate pain education and cognitive approaches into management of chronic pain in patients.
However, only a third of GPs were aware of the National Pain Strategy, the NSW Pain Management Plan and the Agency for Clinical Innovation (ACI) Pain Management Network website, while at least half of non-GP health professionals were aware of them. GPs were also less likely to make direct contact with pain clinics.
At an initial cost of $26 million, the NSW Pain Management Plan has supported 19 pain services, including five new regional Tier 2 services (Orange/Dubbo, Tamworth, Port Kembla, Port Macquarie and Lismore). There are now three paediatric pain clinics, two in metropolitan Sydney and one in Newcastle, as well as a telehealth service through Westmead Children’s Hospital and John Hunter Children’s Hospital, which provides statewide access to specialist paediatric care.
The plan has also funded important research, development of the electronic Persistent Pain Outcomes Collaboration (ePPOC) and patient and health professional education and resources.