Design, participants and setting: Systematic survey conducted between 1 December 2008 and 31 January 2010 of 57 services providing outpatient care to adult clients with persistent pain, plus five specialised paediatric services throughout Australia.
Main outcome measures: Service structure, including funding processes; activity, including client numbers, access to specialised services (inpatient care, pain relief interventions); waiting times; and use of allied-health-professional-based pain management programs.
Results: Of 68 services identified, 57 participated in the study. The median waiting time from referral receipt to initial clinical assessment for a publicly funded outpatient adult pain management service was 150 days, compared with 38.5 days for a privately funded service (P < 0.05). There was substantial variability among providers in range of services offered, including provision and duration of allied-health pain management programs. The level of service provision for children and rural patients is notably lower than that reported for urban adult constituents.
Conclusions: Persistent pain management services are currently unable to meet service requirements adequately, and waiting times are more prolonged for publicly funded than privately funded services. Greater service provision is required in rural areas and for children.
- 1. Blyth FM, March LM, Brnabic AJM, Cousin MJ. Chronic pain in Australia: a prevalence study. Pain 2001; 89: 127-134.
- 2. The high price of pain: the economic impact of persistent pain in Australia in 2007. Report by Access Economics Pty Limited for MBF Foundation in collaboration with the University of Sydney Pain Management Research Institute. November 2007. http://www.bupa.com.au/staticfiles/BupaP3/Health%20and%20 Wellness/MediaFiles/PDFs/MBF_Foundation_the_price_of_pain.pdf (accessed Nov 2011).
- 3. Yang NK, Crane C. Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links. Psychol Med 2006; 36: 575-586.
- 4. Van Leeuwen MT, Blyth FM, Nicholas MK, Cousins MJ. Chronic pain and reduced work effectiveness: the hidden costs to Australian employers. Eur J Pain 2006; 10: 161-166.
- 5. Blyth FM, March LM, Nicholas MK, Cousins MJ. Chronic pain related disability and use of analgesia and health services in a Sydney community. Med J Aust 2003; 179: 84-87. <MJA full text>
- 6. Blyth FM, March LM, Brnabic AJ, Cousins MJ. Chronic pain and frequent use of health care. Pain 2004; 111: 51-58.
- 7. National Pain Summit initiative. National Pain Strategy. Pain management for all Australians. March 2010. http://www.anzspm.org.au/c/anzspm?a=sendfile&ft=p&fid=1320268502&sid= (accessed Nov 2011).
- 8. Morley S, Williams A, Hussain S. Estimating the effectiveness of cognitive behavioural therapy in the clinic: evaluation of a CBT informed pain management programme. Pain 2008; 137: 670-680.
- 9. Eccleston C, Williams AC, Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev 2009; (2): CD007407.
- 10. Linton SJ, Anderson T. Can chronic disability be prevented? A randomised trial of a cognitive-behavoural intervention and two forms of information for spinal pain patients. Spine 2000; 25: 2825-2831.
- 11. Cedraschi C, Desmeules J, Rapiti E, et al. Fibromyalgia: a randomised controlled trial of a treatment programme based on self management. Ann Rheum Dis 2004; 63: 290-296.
- 12. Bowsher D. Factors influencing the feature of postherpetic neuralgia and outcome when treated with tricyclics. Eur J Pain 2003; 7: 1-7.
- 13. Lynch ME, Campbell F, Clark AJ, et al. A systematic review of the effect of waiting for treatment for chronic pain. Pain 2008; 136: 97-116.
- 14. International Association for the Study of Pain. Recommendations for pain treatment services. http://www.iasp-pain.org/AM/template.cfm? Section=Pain_Treatment_Facilities (accessed Jun 2008).
- 15. Peng P, Choiniere M, Dion D, et al. Challenges in accessing multidisciplinary pain treatment facilities in Canada. Can J Anaesth 2007; 54: 977-984.
- 16. Choiniere M, Dion D, Peng P, et al. The Canadian STOP-PAIN project. Part 1: Who are the patients on the waitlists of multidisciplinary pain treatment facilities? Can J Anaesth 2010; 57: 539-548.
- 17. Australian Bureau of Statistics, Australian demographic statistics. June quarter 2009. Released 3 Dec, 2009. (ABS Cat No. 3101.1.) http:// www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/0/FB52766C453652E1CA 25768000196B47/$File/31010_jun% 202009.pdf (accessed Feb 2010).
- 18. Peng P, Stinson JN, Choiniere M, et al. Dedicated multidisciplinary pain management centres for children in Canada: the current status. Can J Anaesth 2007; 54: 985-991.
- 19. van Dijk A, McGrath PA, Picket, et al. Pain prevalence in nine to 13 year-old school children. Pain Res Manag 2006; 11: 234-240.
- 20. Palermo TM, Eccleston C, Lewandowski AS, et al. Randomised controlled trials of psychological therapies for the management of chronic pain in children and adolescents: an updated meta-analytic review. Pain 2010; 148: 387-397.
- 21. Jones G, Macfarlane G. Epidemiology of pain in older persons. In: Gibson S, Weiner D, editors. Pain in older persons: progress in pain research and management. Vol 35. Seattle: IASP Press, 2005: 3-22.
- 22. Lakha SF, Yegneswaran B, Furlan JC, et al. Referring patients with chronic noncancer pain to pain clinics: survey of Ontario family physicians. Can Fam Physician 2011; 57: e106-e112.
- 23. Telehealth — modernising medicine by providing rebates for online consultations. MBS Online. Medicare Benefits Schedule. http://www. mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/mbsonline-telehealth-landing.htm (accessed Mar 2012).
- 24. Davies S, Quintner J, Parsons R, et al. Pre-clinic group education sessions reduce waiting times and costs at public pain medicine units. Pain Med 2011; 12: 59-71.
- 25. Hayes C, Hodson FJ. A whole person model of care for persistent pain: from conceptual framework to practical application. Pain Med 2011; 12: 1738-1749.
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