Pain Management-Balancing Risks and Benefits to Optimize Patient Safety and Outcomes

According to the Centers for Disease Control and Prevention (CDC), an estimated 20.9 percent of U.S. adults, or 51.6 million people, experienced chronic pain in 2021,1 A 2016 study found that more than one-third of hospitalized patients reported severe pain,2 and a 2008 JAMA article noted that acute pain was responsible for 42 percent of emergency department (ED) visits.3 Moreover, the National Academy of Medicine (NAM) reported the annual cost of pain-related medical treatment and lost productivity to be approximately $560 to $635 billion.4 The CDC further states that the prevalence of chronic pain is higher among specific populations, such as older adults, females, impoverished individuals, American Indian and Alaska Native (AI/ AN) adults, and adults with a history of certain chronic medical conditions.5 In addition to investigating and treating its underlying cause, providers who are faced with a patient in pain have an obligation to address the patient's pain directly to relieve suffering and improve well-being. [...]pain management can be a vexing problem for both the patient and the provider. According to the "Chronic Pain Management" section of the office notes, the patient was on the "lowest possible dose with the maximum benefit of the medication therapy of opioids." [...]there was no documented rationale that the benefits of high-dose opioid therapy outweighed the significant risks. [...]after thoroughly reviewing the available medical records, the peer reviewer determined that the documentation did not support that the patient's pain management plan was appropriate for his condition.