The complexity model: a novel approach to improve chronic pain care

Pain Medicine : the Official Journal of the American Academy of Pain Medicine
John F PeppinBill H McCarberg

Abstract

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.

References

Apr 2, 1998·The International Journal of Neuroscience·V TanJ L Esterhai
Jul 3, 1998·The Journal of Head Trauma Rehabilitation·M R HibbardJ Silver
Jul 21, 1998·JAMA : the Journal of the American Medical Association·O GurejeR Gater
Aug 12, 1998·European Journal of Anaesthesiology·S ChrubasikO Stutzke
Mar 25, 2000·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·M R PicciottoV Zachariou
Jul 23, 2003·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Robert FriedmanDeepak Mehrotra
Oct 7, 2003·Behaviour Research and Therapy·Andrea W M EversJohannes W J Bijlsma
Apr 22, 2004·The Clinical Journal of Pain·Dawn A Marcus
Apr 23, 2004·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·H P Rome, J D Rome
Sep 16, 2004·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Scott M FishmanLouis W Sullivan
Mar 19, 2005·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Douglas L GourlayAbdulaziz Almahrezi
Jun 10, 2005·Journal of Rehabilitation Research and Development·Martin D HoffmanPhilip S Clifford
Dec 13, 2005·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Lynn R Webster, Rebecca M Webster
Jul 1, 2006·Journal of General Internal Medicine·Carole C UpshurJudith A Savageau
Jul 25, 2006·Pharmacoepidemiology and Drug Safety·Leonard J PaulozziYongli Xi
Sep 20, 2006·BMC Musculoskeletal Disorders·Debra P RitzwollerDale Rublee
Nov 1, 2006·The Journal of Pain : Official Journal of the American Pain Society·Robert J Gatchel, Akiko Okifuji
Dec 16, 2006·The Journal of Pain : Official Journal of the American Pain Society·Brenda BreuerRussell K Portenoy
Dec 16, 2006·American Journal of Preventive Medicine·Leonard J Paulozzi, George W Ryan
Feb 16, 2007·The American Journal of the Medical Sciences·Jane E O'RorkeSam Cykert
Sep 22, 2007·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Nancy L WiedemerRollin M Gallagher
Oct 16, 2007·Journal of Epidemiology and Community Health·Dean RicklesAlan Shiell
Dec 20, 2007·The Journal of Pain : Official Journal of the American Pain Society·C Richard ChapmanChan Woo Song
Feb 22, 2008·The Clinical Journal of Pain·Bionka M A HuisstedeSusan Picavet
Jun 28, 2008·BMC Musculoskeletal Disorders·Gabriella M van DijkJoost Dekker
Jul 8, 2008·The Journal of Pain : Official Journal of the American Pain Society·Adley TsangMakoto Watanabe
Jul 29, 2008·Hernia : the Journal of Hernias and Abdominal Wall Surgery·K J DickinsonC M White
Aug 14, 2008·JAMA : the Journal of the American Medical Association·Devi E Nampiaparampil
Oct 2, 2008·Journal of Homosexuality·Edward Chan, Chris Cavacuiti
Nov 11, 2008·Annals of the New York Academy of Sciences·David P Graham, Aaron L Cardon
Dec 5, 2008·Journal of the American Geriatrics Society·Lucas H McCarthyRichard B Lipton
Jan 30, 2009·Arthritis and Rheumatism·J N BeloS M A Bierma-Zeinstra
Feb 4, 2009·The Journal of Pain : Official Journal of the American Pain Society·Roger ChouUNKNOWN American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
Feb 4, 2009·World Journal of Surgery·Kamran Zargar-Shoshtari, Andrew G Hill
Feb 7, 2009·Obesity·Anne LübbekePierre Hoffmeyer
Feb 11, 2009·Journal of Neurotrauma·James M Bjork, Steven J Grant
Feb 27, 2009·Current Opinion in Pediatrics·Gilbert Chan, Christopher T Chen
Mar 4, 2009·The Journal of Pain : Official Journal of the American Pain Society·Marcella DanielLori A Bastian

❮ Previous
Next ❯

Citations

Nov 29, 2015·The Medical Clinics of North America·Martin D Cheatle
May 12, 2016·Postgraduate Medicine·Steven StanosStephen Watt
Jul 25, 2019·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Johnny M HoangMeghana V Trivedi
Apr 30, 2019·Scandinavian Journal of Pain·Rebecca ChernerCatherine Smyth
Jun 14, 2017·International Journal of Clinical Pharmacy·Francisca N WagemaakersMieke L van Driel
Nov 4, 2017·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Ann E Hansen, Norman J Marcus
May 1, 2021·Rheumatology Advances in Practice·Alisa J JohnsonStaja Q Booker
Oct 5, 2021·Journal of Clinical Psychology in Medical Settings·Ana-Maria VranceanuUNKNOWN International Musculoskeletal Mental and Social Health Consortium (IMESH)

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

The Journal of Family Practice
JoAnne M SaxeKellie McNerney
Journal of Occupational Medicine. : Official Publication of the Industrial Medical Association
L C McGee
Nursing Times
J Bartholomew, S Proctor
© 2022 Meta ULC. All rights reserved