How one website has made a difference to people experiencing chronic pain

Hester Wilson

27/06/2018 12:08:06 PM

Dr Hester Wilson recalls her experiences in helping to develop the Pain Management Network website, a new tool for patients and healthcare professionals.

Dr Hester Wilson has used online tools to educate patients and help reduce opioid use for chronic non-cancer pain.
Dr Hester Wilson has used online tools to educate patients and help reduce opioid use for chronic non-cancer pain.

One of my patients – let’s call him Stu – is a 57-year-old man who has a past history of recurrent lower back pain following a serious motor-vehicle accident in his 20s. He suffered significant complications following abdominal surgery and ended up being discharged on large doses of OxyContin.
Stu came to see me with his wife, who reported that she was really worried about his use of OxyContin. A man of few words, Stu said he was concerned that he couldn’t stop, and both he and his wife were concerned about how it was affecting his mood and their relationship.
I showed them the Pain Management Network website. Stu particularly liked the information on nutrition, while his wife liked the information on pain pathways. We used the information on de-prescribing to help plan a slow reduction, which he managed over a five-month period.
Stu is now opioid-free and managing his pain, which he says has actually improved since stopping the meds, with exercise, physio and meditation. The last time I saw Stu’s wife she said she was so much happier with how life is for them now.
It was quite a turnaround. Stu had nearly died when he was in hospital following the surgery. His wife thought she was going to lose him. But even after he recovered from that, the opioids changed her husband so much that she’d felt she had lost him anyway.
‘Now I have him back,’ she told me.
So why did I show them the Pain Management Network website?
Because it clearly lays out how someone can best manage their chronic non-cancer pain and offers pathways to a better quality of life without opioids.
About three years ago one of my general practice colleagues dobbed me in to the NSW ACI (Agency for Clinical Innovation), suggesting that I would be a good GP to be involved in their pain management website.
I had never heard of the ACI prior to this, but I now know the agency, funded by NSW Health, supports several networks to drive clinical improvements, including the Pain Management Network.

This Pain Management Network consists of a group of pain specialists – doctors, nurses, physios, counsellors and so on – mostly working in public multidisciplinary pain clinics around NSW. The goal of the website is to assist clinicians and patients to better manage chronic non-cancer pain.

Being a publicly funded organisation, one that assists clinicians in the NSW public health system, involving primary care has been one of the Pain Management Network’s challenges, and this is where I came in.
While I felt chuffed to be asked and readily agreed to be involved, I always think it’s impossible for an individual to be ‘representative’ of a group. And this is particularly true in the case of GPs, who are diverse clinicians, working in very diverse situations around the country.
So I got involved with the knowledge that I was just one GP, albeit one who could have a role in raising awareness and making sure the relevant pain-management issues for GPs were on the table with this specialist group.
The people within the network are experts in pain management in the specialist setting. However, like many specialist services and specialist clinicians, though they have experience as users of general practice and may have a GP background, they acknowledge that they don’t have a full understanding of the challenges, constraints or work conditions in general practice today.

My role with the network was being involved in the creation of content for the website, in particular the PainBytes section, which was put together to help in the quick assessment and planning of care for a clinician seeing a patient with pain. This section is particularly useful for us in general practice.
I’ve been involved as the site has developed further. It has a Quick Steps section offering eight steps to help GPs manage chronic non-cancer pain in the community.
I particularly like the patient videos, as well as a number of other videos that explain what chronic pain is and that you can ‘retrain your brain’. I’ve used these ideas and videos with my patients, many of whom have the lightbulb moment when they realise that their perception of pain can be altered.

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Michael Mulholland   3/07/2018 9:14:23 PM

Hi Hester,
Great contribution to the website!
Yes it is an excellent resource. I also refer patients to it. The videos have informed my patient education material and I draw less diagrams now.
It is helpful with individual patients and small self management groups that I run.
Many thanks