In Canada, 17% of Canadians are diagnosed with chronic pain and 37% of visits to Family Practices involve chronic pain issues. There has been a 242% increase in opioid prescriptions for pain over the last 20 years with a similar rise in opioid addiction. There has been double the number of opioid related deaths over the last 20 years.
The Healthy Living with Pain (HeLP) Program was developed by the Mount Sinai Academic Family Health Team (FHT) to address the growing health issues of our patients with chronic pain on long term opioid medication using an Interdisciplinary team approach that promotes best practice models to ensure safe and appropriate prescribing, and optimal pain management. The program strives to help individuals obtain the best pain control and achieve better quality of life, while supporting patients by providing continuity of care in an academic teaching environment.
The program was developed after a quality improvement initiative demonstrated that our FHT was not serving our population with chronic pain optimally. Concerns were expressed by patients and providers about opioid prescribing, continuity of care, and inadequate pain control. Our solution was to design an innovative interdisciplinary program, led by a nurse practitioner with advanced skills in assessing and managing patients with chronic non cancer pain. We identified a roster of patients who would benefit from the program and organized team meetings to discuss and coordinate care. We developed a chronic pain flowsheet in the electronic health record to improve communication, thoroughness of assessments and record keeping. We also developed standards for holding regular chart reviews and discussions with faculty supervisors and the multidisciplinary team, and standards for care provision, such as urine drug screening and safe prescribing practices.