Calls for expansion of multidisciplinary pain management

Mental health issues, relationship strains, stigma and isolation are regularly experienced by the 3.6 million Australians living with chronic pain.

The details of the widespread impacts of what is often described as an ‘invisible condition’ are laid bare in the 2024 National Pain Report from Chronic Pain Australia (CPA), which reveals findings from the country’s longest-running national pain survey.
 
Collating feedback of almost 2600 participants, the report was launched to mark National Pain Week and strengthen calls for expansion of multidisciplinary pain management programs across Australia.
 
CPA is calling for the programs to be funded in primary care settings to support GPs and their patients experiencing chronic pain.
 
These evidence-based models of care are considered the ‘gold standard’ to addressing complex pain conditions, but according to CPA, there are currently just six in operation across Australia.
 
The National Pain Survey found the vast majority of people living with chronic pain do not have access to multidisciplinary pain management, with only one in five having been referred to a program or clinic.
 
Despite this, 72% of those who had received multidisciplinary care would recommend it to others.
 
Leveraging its calls with these responses, CPA is urging for existing primary health networks to be nationally funded to deliver dedicated primary care multidisciplinary pain management programs – a model it says would be ‘lifechanging for many’.
 
Dr Adele Stewart is a GP and Chair of RACGP Specific Interests Pain Management and told newsGP the role of GPs in pain management is ‘multifaceted and crucial’.
 
‘As primary care providers, GPs are often the first point of contact for patients experiencing chronic pain. Our role is crucial in early identification, ongoing management, and, perhaps even more importantly, continuity and coordination of care,’ she said.
 
‘GPs can provide valuable insights into patient histories, comorbidities, and social factors that influence pain, ensuring that treatment is holistic and patient centred.’

The National Strategic Action Plan for Pain Management recommends that in most cases, people living with pain can be best supported in primary care, with only a ’small proportion’ requiring tertiary care.
 
The RACGP has come out in strong support of GP-led multidisciplinary teams which align with the Strengthening Medicare Taskforce Report, and its opioid guidelines recommend this approach to pain management.
 
However, the college does outline concerns around the fragmented approach to primary care funding in its funding priorities position statement.
 
Stigma and barriers to care are common themes highlighted in the National Pain Survey, with nine in 10 respondents between the ages of 18–34 reporting feeling ‘ignored or dismissed’ by health professionals.
 
Worryingly, significantly more in this age group have had thoughts of self-harm, suicide, or have made a suicide attempt.
 
While cost is the greatest barrier (66.2%) to accessing care for chronic pain management, finding a supportive doctor and associated stigma are also key challenges.
 
But RACGP President Dr Nicole Higgins told newsGP managing chronic pain is best done by a GP and their team, who know the patient.
 
‘This is in line with our advocacy, because we don’t want to fragment care, and chronic pain is complex, it doesn’t exist in isolation, so we have to look at the whole person,’ she said.
 
‘GPs have a really strong role in reducing that stigma, and therefore there’s an opportunity for general practice, for GPs, and their teams to be the advocates for their patients.’
 
Despite 37.6% of respondents feeling stigmatised by their GP and 47.6% by other health professionals, GPs are still considered the most trusted source of information on chronic pain.
 
Given this stigma, Dr Stewart believes GPs must approach chronic pain with compassion and understanding, as well as actively listening to patients’ experiences and concerns without judgement.
 
‘It’s important to validate their pain and reassure them that chronic pain is a legitimate medical condition that deserves proper management,’ she said.
 
‘Clear and open communication is also key. GPs need to educate patients about the nature of chronic pain, available treatment options, and the risks and benefits of each.
 
‘This transparency can help reduce fear and misconceptions and enable shared decision-making to foster a sense of control and partnership, which can enhance trust and adherence to the treatment regimen.’
 
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