Healthcare News & Insights

Changes proposed to hospital pain management

To curb the growing trend of prescription drug abuse in the U.S., hospitals are being challenged to change the way they assess and treat patients’ pain. Some groups are even pressuring the feds to revamp how they present pain management to hospitals. 

According to an article from the Associated Pressprescription form with stethoscope, several medical officials and nonprofit groups just sent a letter to the Joint Commission, asking the agency to change its accreditation criteria for pain management in hospitals.

Specifically, the biggest issue was with the commission’s recommendation for doctors to routinely ask patients to assess their levels of pain.

Per its website, the Joint Commission currently requires hospitals to:

  • recognize patients’ right to appropriate assessment and management of their pain
  • screen patients for pain both during their initial health assessments and during any subsequent reassessments, as medically necessary, and
  • educate patients about pain management.

The commission encourages hospitals to take a patient-centered approach to managing pain that considers “the patient’s current presentation, the healthcare providers’ clinical judgment, and the risks and benefits associated with the strategies.”

In many hospitals, pain is treated as a “vital sign,” monitored the same way as elements such as body temperature and blood pressure. But critics say this encourages doctors to prescribe strong painkillers in situations where they may not be necessary.

Other strategies to use

Instead of automatically turning to opioids or other strong drugs to manage pain, hospitals need to take different approaches. The Joint Commission currently recommends that hospitals try a variety of strategies for pain management, stating that “both pharmacologic and nonpharmacologic strategies have a role in the management of pain.”

Suggested strategies that don’t involve prescription drugs include:

  • chiropractic therapy
  • massage therapy
  • osteopathic manipulative treatment
  • physical therapy
  • acupuncture therapy
  • relaxation therapy, and
  • cognitive behavior therapy.

Pain & patient satisfaction

Another change the group wants to make is to remove questions about pain management from patient satisfaction surveys administered by the Centers for Medicare & Medicaid Services (CMS).

Here’s why: Experts say that relating pain to patient satisfaction may unconsciously lead doctors to prescribe opioid painkillers excessively to make patients happy, regardless of whether alternate pain management methods would be better choices.

New mindset

These developments mean that many hospitals may have to rethink their approach to pain management. Even if these changes don’t go through, a facility’s best bet is to consider opioids a last resort for patients.

Because there are so many options available to manage patients’ pain, doctors should exhaust several other alternatives before writing prescriptions for opioids. Clinicians should still be proactive about assessing and addressing patients’ feelings of pain, but alternative approaches can be just as effective in many cases.

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