Collaborations between palliative care specialists and pain medicine physicians can help optimize care for seriously ill patients, new research has found.
Chronic pain can be debilitating and often accompanies serious conditions that can warrant palliative care, such as cancer. Between 2019 and 2021, the prevalence of chronic pain among adults nationwide ranged from 20.5% to 21.8%, and the prevalence of high-impact chronic pain ranged from 6.9% to 7.8%, according to the U.S. Centers for Disease Control and Prevention (CDC).
The new study appeared in the Journal of Pain and Symptom Management.
“Although we found that [palliative care] physicians have highly positive attitudes about the value of [pain medicine] specialists, referral rates remain low, even for [implantable drug delivery system] implantation, which has perhaps the largest body of evidence for patients with complex cancer-associated pain,” researchers wrote. “Facilitating professional collaboration via joint educational/clinical sessions is one possible solution to drive ongoing interprofessional care in patients with complex pain.”
For the study, researchers developed a 30-question survey in collaboration with palliative care specialists and experts from the Mayo Clinic Survey Research Center. A survey expert also assisted with the questionnaire.
The survey contained 11 demographic questions, 16 about physician collaboration and three to assess palliative care provider attitudes about working with pain specialists. The survey was administered to 1,000 physician members of the American Academy of Hospice and Palliative Medicine (AAHPM), with a 52.6% response rate.
About 95% of the surveyed palliative care physicians surveyed recognized the importance of interventional pain management. More than 91% of the physicians favored interventional pain management procedures for cancer pain and 73.5% favored pain medicine specialists making medication for chronic non-cancer pain.
However, 68.3% of the palliative care physicians made fewer than 10 referrals to pain medicine specialists annually, the study found.
More research is necessary to further explore palliative care to pain medicine referrals, the authors concluded.
“Further research could more deeply explore elements of institutional structures that foster a collaborative environment between PC and PM specialists,” study authors wrote. “While PC specialists are uniquely trained to address the psychosocial elements of patient suffering and address some of the challenges of appropriate opioid utilization, the fact remains that PM specialists are able to provide critically important services including clinical knowledge and procedural skills to help care for patients with serious illness.”
