Background & Aims

Healthcare has seen a growing emphasis on addressing chronic conditions like chronic pain, particularly in the wake of the COVID-19 pandemic. However, traditional medical training has often prioritized acute care over chronic disease management. This has led to challenges in providing comprehensive care for conditions like chronic pain and limitations in access to effective pain treatment. Efforts to transition towards more holistic, integrated care models have been hindered by their complexity and costliness despite substantial evidence that these models can provide improved care and patient outcomes while being cost-effective. Transdisciplinary pain care, more so than other popularized models, is an ideally suited integrated care solution to fulfill the quadruple aim of improving population health, enhancing the patient care experience, reducing costs, and improving satisfaction.

Methods

Chronic pain treatment has a substantial focus on passive therapies such as pharmacologic and interventional treatment, but limitations exist making these solutions incomplete for many suffering from complex chronic pain. Additionally, access to important biopsychosocial components of care like physical therapy and pain psychology is often restricted due to limited payer coverage or regional availability.
Despite advocacy for patient-centered care due to the substantial burden of high-impact chronic pain on stakeholders, integrated care models have had limited implementation in the treatment of chronic pain. While likely multifactorial, healthcare providers often have insufficient familiarity with integrated care concepts for pain. The terminology utilized to describe integrated pain models (including multidisciplinary, interdisciplinary, and transdisciplinary care) often lacks clear definitions and further complicates their use in improving chronic pain management.

Results

Multidisciplinary care, the most common approach to care delivery, involves sequential referrals to various specialists. However, this model lacks coordination and structure, resulting in fragmented care and suboptimal outcomes. Interdisciplinary care improves upon this by fostering collaboration among providers, but challenges remain in communication and care coordination.
Transdisciplinary care represents the pinnacle of collaborative care. Providers integrate their expertise to tailor individualized treatment plans for each patient. This ensures comprehensive care and maximizes patient engagement, leading to improved outcomes and satisfaction for both patients and providers. Despite its potential benefits, widespread adoption of this model faces challenges, including cost implications and the need for clear communication among providers. However, the implementation of value-based repayment systems could mitigate costs and promote the adoption of this transformative model.

Conclusions

In conclusion, transdisciplinary care offers a promising solution to the shortcomings of traditional chronic pain management approaches. Prioritizing collaboration and patient-centered care, aligns this model with the quadruple aim described to optimize health system performance, ultimately leading to improved patient outcomes, reduced healthcare costs, and enhanced clinician and patient satisfaction. The implementation of the transdisciplinary chronic pain care model has the potential to improve access to comprehensive, biopsychosocial, pain treatment through improved provider communication and patient engagement, while utilization of novel payer systems can abate the high burden of chronic pain related costs.

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Presenting Author

Jacob Gross

Poster Authors

Jacob Gross

MD, MPH

University of Washington

Lead Author

E-mail

John Sturgeon

PhD

University of Michigan

Lead Author

E-mail

Michael Kriegel

PhD

Kriegel and Associates

Lead Author

E-mail

Sergey Borodianski

MD

WellSpan Health

Lead Author

E-mail

Aleksandra Zgierska MD

PhD

Penn State University

Lead Author

E-mail

Tobias Moeller-Bertram

MD

Savas Health

Lead Author

E-mail

Kayode Williams

MBBS

Johns Hopkins

Lead Author

E-mail

W. Michael Hooten

MD

Mayo Clinic

Lead Author

E-mail

Miroslav Backonja

NIH

Lead Author

E-mail

Victor Wang

MD

Boston Pain Care

Lead Author

E-mail

Topics

  • Access to Care