INTERNATIONAL INITIATIVES

Michael J Cousins AM MD DSc FRCA FANZCA FFPMANZCA FAChPM (RACP)

Pain Management Research Institute University of Sydney

Royal North Shore Hospital, St. Leonards Australia

Pain Management inadequate in most of the world:

• Inadequate access to treatment of acute, chronic and cancer pain

• Major deficits in knowledge

• People with chronic pain are stigmatised

• Most countries – No National Pain Policy

INTERNATIONAL INITIATIVES

• IASP International Pain Summit – Declaration of Montreal

– Desirable Characteristics of NPS’s

• European Chapters of IASP 2011 “Road map for development of Pain Services”

• Institute of Medicine, USA 2011

“a blueprint for transforming prevention,

care, education & research”

And recognizing the intrinsic dignity of all persons:

Article 1: The right of all people to have access to pain management without discrimination

Article 2: The right of people in pain to acknowledgement of their pain and to be informed about how it can be assessed and managed

Article 3: The right of … access to appropriate assessment and management…by adequately trained health professionals

HUMAN RIGHTS and PAIN

• Since the Declaration of Montreal

• IFHHRO “Denial of Pain Relief ” 2010-11

• World Medical Association Council Oct 2011

Resolution: Pain management a human right

• “Pain Crisis”

March 2, 2011

November, 2009

Australian Pain Summit

• 150 health care , consumer and other organizations

• Supported the national strategy

• Similar objectives to the Canadian pain Strategy – Awareness and education/destigmatization

– Access to care

– Research

National network of healthcare, consumer and related organisations Registered not for profit charity Mission: “To improve quality of life for people with pain and their families, and to minimise the burden of pain on individuals and the community, by facilitating implementation of the National Pain Strategy (NPS)”

Painaustralia - Outcomes

• Statewide pain plans: NSW, Qld, WA – QLD $39 Million over 4 years for statewide plan

• Guidelines for minimum multidisc staff

• Screen and referral guide

• Training and ed

– WA $50,000 support Pain Australia • Endorse the NPS

• Models of care spinal pain and inflammatory arthritis

– NSW Ministerial task force report October 2011 • Funding expected first half 2012

OTHER INITIATIVES IN AUSTRALIA

• Academic Discipline of Pain Medicine - USYD

• Inaugural Pain Symposium (6 hrs) March 2012 – 300 medical & other health science students

• On-line Pain Educn Prog for 1ry Care

RACGP/Faculty Pain Med Sept 2012

• Cancer Pain Guidelines

• Promulgation of WHO Paediatric Guidelines

INAUGURAL PAIN SYMPOSIUM March 2012

Conclusions

• A national pain strategy is critical in order to address the major gaps in education, care and research re pain

• The ideal solution will involve federal leadership to assure all citizens have access to the same level of best practice care

• Continued advocacy is essential to assure good pain care for all because access pain management is a fundamental human right