Effective pain management in individuals who are chemically dependent upon prescription drugs, either by illicit or other means, pose a challenge to the quality of care among hospice patients. The hospice model of care is holistic, encompassing mind, body, and spirit with a interdisciplinary approach in effective pain and other symptom management, emotional and spiritual support that embraces quality of life for patients and their families (NHPCO, 2013). In 2012, an estimated 1.5 to 1.6 million patients in this country were provided hospice care services with 66% of care provided in the home (NHPCO, 2013).
The Substance Abuse and Mental Health Administration (SAMHSA) reported approximately 22.6 million Americans over the age of 12 reported the use of illicit substances in the previous month in 2010 (SAMHSA, 2011). This rise in chemical dependence among patients may be the reason for increased caution among physicians who are more reluctant to change pain medication regimens. Patients experiencing poorly controlled pain is common leading to impaired quality of care. It has been noted that upwards of 50% of patients suffer from poorly treated pain (Nekolaichuk et al., 2013)
Institute of Medicine Six Aims
The Institute of Medicine (IOM) described six areas of focus for the improvement of health and quality of care delivered to patients across the continuum of care that includes safe, effective, patient-centered, timely, efficient, and equitable in the public and private sector of the health care system resulting in a decreased burden of illness, injury and disability to those in the care of health professionals (IOM, 2001). In the case of patients who have poorly controlled pain as a result of being known as “chemically depe...
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...agement in patients with substance use disorders. Pain Management Nursing 13(3). 169-183. Retrieved from http://www.aspmn.org/Organization/documents/PainManagementinPatientswithSubstanceAbuseDisorders.pdf
Substance Abuse and Mental Health Services Administration (SAMHSA)(2011). Results from the 2010 national survey on drug use and health: Summary of national findings (NSDUH series H – 41, HHS publication no. (SMA) 11-4658). Rockville, MD: Substance Abuse and Mental Health Services Administration. In Oliver, J., Coggins, C., Compton, P., Hagan, S., Matteliano, D., Stanton, M., et al. (2012). American Society for pain management nursing position statement: Pain management in patients with substance use disorders. Pain Management Nursing. 13(3) 169-183. Retrieved from http://www.aspmn.org/Organization/documents/PainManagementinPatientswithSubstanceAbuseDisorders.pdf