World-first pain strategy

A world-first national pain strategy has been drafted by researchers including the University of Sydney's Professor Michael Cousins.

Pain management in Australia is shockingly inadequate and yet it is the commonest symptom doctors are confronted with every day, according to Professor Cousins, an internationally renowned pain specialist.

Professor Cousins, who is head of anaesthesia and pain management at the University of Sydney, has released the initial draft of the world-first National Pain Strategy, to be finalised at the National Pain Summit in Canberra on March 11, 2010.

The strategy's aim is to have the management of pain addressed as part of the Rudd Government's national health reforms.

The groundbreaking draft strategy, the result of thousands of hours' work by more than 70 pain medicine specialists, other health professionals and consumers, is now open for community and expert input.

The draft strategy includes recommendations that:

• Chronic pain be recognised as a disease in its own right;
• Pain be given a diagnostic code along with other chronic diseases to document its prevalence, outcomes and costs;
• When monitoring patients, pain be included as the fifth vital sign (with blood pressure, heart rate, temperature and breathing rate);
• More effort is made to de-stigmatise pain (similar to the successful campaigns to de-stigmatise depression).

"Pain is one of the biggest health issues in Australia today - every bit as big as cancer, AIDS and coronary heart disease," said Professor Cousins, who is the chair of the summit steering committee.

The summit, which is being led by the Australian and New Zealand College of Anaesthetists, Faculty of Pain Medicine, the Australian Pain Society and Chronic Pain Australia in collaboration with inaugural supporters' MBF Foundation and the Pain Management Research Institute, will bring together an unprecedented gathering of over 200 leading authorities in pain medicine, consumer groups and other health professionals.

Professor Cousins said chronic pain was the third most costly health problem in Australia and yet pain management was not on the national health agenda.

"Australia is leading the world in developing a National Pain Strategy," Professor Cousins said, adding that there was a worldwide move by bodies such as the World Health Organization to improve treatment of pain.

"Even an apparently simple problem such as acute pain after surgery or trauma is not satisfactorily relieved in over 50 per cent of patients," said Professor Cousins. "In patients with cancer pain, again, 50 per cent do not obtain adequate relief.

"The situation is much worse for the one in five Australians who suffer chronic pain such as back pain or persisting pain after surgery or injury. Less than 10 per cent of the three million people in this group gain access to effective treatment, costing the economy over $34 billion each year.

"These are shocking statistics because severe pain destroys all aspects of individual and family activities."

Chronic pain - that is, constant daily pain for a period of three months or more - costs the economy an estimated $34.4 billion per annum, or $10,847 per person affected, according to the MBF Foundation report "The High Price of Pain" conducted by Access Economics.

The report also found that more than 36.5 million working days were lost each year due to chronic pain, costing the economy and employers $11.7 billion annually in productivity losses.

The chair of the National Health and Hospitals Reform Commission and MBF Foundation steering committee, Dr Christine Bennett, said Australia was entering a historic era of reform in health.

"The redesigned health system will need to meet emerging challenges with a greater emphasis on preventative health and more effective management of chronic diseases such as pain," Dr 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," Dr Bennett added.

"The National Pain Strategy, which draws on the expertise of a broad base of stakeholders, outlines a blueprint for its effective management and is ideally timed to be heard by policy makers."

The strategy recommends that chronic pain be recognised as disease in its own right.

"The concept of pain as a disease is a new one but it has been adopted by European members of the International Association for the Study of Pain (IASP) who have made recommendations to the European parliament that chronic pain be recognised as a disease," Professor Cousins said.

"All patients in hospital should be asked what level of pain they are experiencing on a scale of 0 to 10," Professor Cousins said.

"In the same way that we won't know if a patient has a fever if we don't take their temperature, if we don't document their pain, it won't be treated and we won't be able to see if their pain is improving."

The draft National Pain Strategy can be found at www.painsummit.org.au

To speak to Professor Michael Cousins please contact National Pain Summit media manager Clea Hincks on 0418 583 276

Contact: Sarah Stock

Phone: 02 9114 0748