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Ed Coghlan
The results of a robust poll written by Terri Lewis, Ph.D. and promoted by the National Pain Report were shared with the US Food and Drug Administration before the public meeting of 9 July for Development of Patient-Focused Drugs on Chronic Pain
"We received response from not only chronic pain patients, but doctors and caregivers," noted Dr. Lewis This has shown that many people are suffering and are excluded from the conversation. That's the message the FDA needs to hear. "
Nearly 1700 people responded and all 50 states had significant participation, 80% of respondents were women and most were in the age category of 40 to 65.
" What was remarkable was that there were an average of five comorbidities of people who had been sick for twelve years, "she says." There are 25,000 lines of commentary data where people can tell their own stories. "
We will cover Dr. Lewis' presentation in two stories.
In the first part, we will examine the barriers to care that were revealed in the survey that were shared with the FDA. part two – we will review some of the recommendations that Dr. Lewis made to the FDA, which will be part of the testimony of the July 9 meeting and will become part of the Federal Register.
Here's what she found (and (19659003) [1945] 9010] Obstacle 1: Insurance problems occupy an important place in all systems
"I do not have a health care team. I depend on my doctor for my medication, I am poor, I have no one to help me and my insurance does not cover the extra costs. "
Obstacle 2: Regulatory interference in decision-making, destabilization of care and treatment" I would like my health care team to take into account my contribution and needs, but they are now more concerned about CDC guidelines and have problems with the DEA. I've had my primary care physician and my family. Barrier 3: Physicians retire from traditional roles in caregiving
"J & # 39; have tried to educate as much as I can and value for doctors Barrier 4: Risk stratification is now based on the determination whether the physician can avoid DEA by balancing the workload to serve <90 criteria MS (based on assumptions about thresholds of dependence) rather than serving the confirmed needs of patients for specific progressions of the disease
Barrier 5: The increase in Administrative Requirements of Service Physicians Broken Communication and Working Alliance "
" I would like a computer system for ALL my doctors to see that my files can communicate easily and reduce repeated tests. [1] 9659003] Obstacle 6: The practice of pain management suborned ethical care based on the medical necessity of avoiding risk and paying increased attention to dispensing procedures aimed at increase revenue in an increasingly small environment. Pain management, I received injections of different types as well as my pain medications. I stopped going there because of the fact that to get my pain medication, I had to submit to injections that did not relieve me.
Barrier 7: Across the country, physicians are shunning private practice with regulatory interference and hospital closures, factors that affect affordable, accessible and integrated care – particularly in rural areas.
"I have to travel 450 one-way miles for a pain relief physician who understands the CRPS / RSD. I really wish there was someone nearer who could take care of my prescribing needs for a quality of life. Making the trip is very difficult and puts me in a rocket. "
Barrier 8: The acute model of medical care fails people with multiple chronic diseases and leads to increased allocation of failed interventions while increasing use and costs. [19659004] "I do not have a formal care team. My "team" is made up of my family members, doctors and pharmacy. If necessary, I can get nursing home care. All of this requires some coordination and we work together to move things forward.
Obstacle 9: The people most affected by decisions are excluded from the table and from the design of inputs, activities, results
"Affected persons" are the people affected several chronic comorbid diseases (at least two confirmed conditions requiring care), their caregivers and their family members
. Lewis pointed out in an interview this week that the voices of the chronically ill are not often heard. She believes this survey is a starting point for getting more information in the field to educate the government, insurers, medical providers and patients about what "really happens to these people.
Dr. Andrew) Kolodny targeted, "she said," they are people with complex illnesses who often need palliative care and who do not get it. "
In the second part, we will examine Dr. Lewis's recommendation to the FDA.
Public meeting on the development of patient-centered drugs for chronic pain,
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