Peppin John F, Cheatle Martin D, Kirsh Kenneth L, McCarberg Bill H
••, Mallinckrodt Pharmaceuticals, Hazelwood, Missouri, USA.
Pain Med. 2015 Apr;16(4):653-66. doi: 10.1111/pme.12621. Epub 2015 Mar 6.
More than 25% of the US population experiences chronic pain; yet few physicians specialize in the field of pain medicine. This article will review a theoretical model of care that stratifies treatment and patients by level and type of complexity and promotes communication between specialist and primary care providers.
The undertreatment of pain was recently brought to national attention to encourage both clinicians and patients to advocate for improved pain care. The specialty of pain medicine and models of care, challenges of managing pain in a primary care setting, and the reliance on an opioid-focused approach are reviewed. An evolved model of pain care based on the complexity of pain and emphasizing a dynamic collaboration between the primary care provider and the pain specialist is discussed.
From the perspective of the busy clinician, the treatment of chronic pain can be overwhelming. The scarcity of trained pain practitioners and the burgeoning number of patients with chronic pain necessitate a new approach that values the complex nature of chronic pain and offers a practical blueprint to meet these challenges.
超过25%的美国人口经历慢性疼痛；然而，很少有医生专门从事疼痛医学领域的工作。本文将回顾一种护理理论模型，该模型根据复杂性水平和类型对治疗和患者进行分层，并促进专科医生和初级保健提供者之间的沟通。
疼痛治疗不足最近引起了全国关注，以鼓励临床医生和患者倡导改善疼痛护理。本文回顾了疼痛医学专业和护理模式、在初级保健环境中管理疼痛的挑战以及对以阿片类药物为重点的方法的依赖。讨论了一种基于疼痛复杂性并强调初级保健提供者与疼痛专科医生之间动态协作的疼痛护理进化模型。
从忙碌的临床医生的角度来看，慢性疼痛的治疗可能会让人应接不暇。受过培训的疼痛从业者稀缺，而慢性疼痛患者数量不断增加，这就需要一种新方法，该方法重视慢性疼痛的复杂性，并提供应对这些挑战的实用蓝图。
