Grant: Op. Gr: Ev. of Interv. to Address Opioid Crisis- Non-pharm. interv. in pain mngt

Chronic pain affects at least 15% to 29% of the population in Canada, and as the population ages this number is expected to increase along with disability and healthcare costs. Moreover, epidemiological studies have shown increased opioid prescribing trends for chronic pain without good efficacy data to support the practice. In recent years the unintended consequences of long-term opioid use have emerged including increases in pain, medical comorbidity, disrupted sleep architecture, and psychological symptoms. Data consistently show that psychological factors strongly predict opioid receipt and dose, with physicians prescribing opioids to treat these psychological factors that influence their patients' experience of pain. Furthermore, suboptimal prescribing may account for poor pain control and adverse patient outcomes seen commonly in pain therapy. In response to the mounting concern relating to the significant risks associated to opioid use, guidelines have been issued for prescribing opioids that incorporate nonpharmacological interdisciplinary treatment options into care plans for patients with chronic, non-cancer-related pain. For this study, we will document and evaluate the feasibility and preliminary efficacy of an interdisciplinary primary care pain management approach, combining physicians, behavioral specialists, nurse case managers, physical therapists and pharmacists, to reduce pain catastrophizing, inappropriate prescriptions and opioid use and misuse. We will evaluate the organisational, structural, patient, provider, and health innovation factors that influence the successful implementation and sustainability of the program. The results of this feasibility study will provide key recommendations for patients, clinicians, administrators and decision-makers to reduce human suffering, pain treatment costs, and chronic debilitation by addressing the factors that maintain and worsen the pain experience.