Health and service needs, priorities and initiatives of primary health networks related to chronic pain
Simone De Morgan A B * , Pippy Walker
A B , Fiona M. Blyth B C , Leah Marks A B , Lucie Rychetnik B , Michael Nicholas D , Duncan Sanders D and Andrew Wilson A B
A Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, University of Sydney, Charles Perkins Centre D17, Camperdown, NSW 2006, Australia.
B The Australian Prevention Partnership Centre based at the Sax Institute, Level 3, 30C Wentworth Street, Glebe, NSW 2037, Australia.
C School of Public Health, Faculty of Medicine and Health, The University of Sydney, Edward Ford Building A27, Camperdown, NSW 2006, Australia.
D Pain Management Research Institute, The University of Sydney, Ground Floor, Douglas Building, Royal North Shore Hospital, St Leonards, Sydney, NSW 2065, Australia.
Australian Journal of Primary Health 28(5) 417-427 https://doi.org/10.1071/PY21209
Submitted: 24 August 2021 Accepted: 25 April 2022 Published: 24 June 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Chronic pain is a major and growing public health issue. Multidisciplinary tertiary pain services cannot meet patient demand and greater involvement of primary care is needed. The aims of this study were to understand the needs and priorities of Australian primary health networks (PHNs) related to the management and secondary prevention of chronic pain; map current PHN chronic pain initiatives and identify gaps; highlight key enablers to implementation; and highlight solutions identified by PHNs to increase capacity to commission initiatives.
Methods: Mixed methods were used, including: a review of PHN needs assessments; and consultation with PHN executive-level staff and program managers from 27 out of the 28 PHNs, and the WA Primary Health Alliance (WAPHA – a state alliance between three Western Australian PHNs) via telephone interviews, online surveys, a workshop, a deliberative dialogue and email consultation.
Results: Chronic pain was identified as a health and/or service need by approximately half of PHNs. Barriers for PHNs to identifying chronic pain as a need or priority are highlighted. Gaps identified by the mapping included: initiatives related to the secondary prevention of chronic pain (post-surgery or post-injury), digitally enabled consumer and health professional chronic pain initiatives, and chronic pain initiatives for specific populations groups such as Aboriginal and Torres Strait Islander people. Among existing PHN practice, two exemplar evidence-based initiatives suitable for scale-up across PHNs in Australia were identified: multidisciplinary community-based pain programs, and an online health professional capacity-building initiative, Project ECHO (chronic pain). Solutions identified by PHNs to increase capacity to commission initiatives included: co-funding initiatives across different PHN funding streams, collaborative initiatives between PHNs, and co-commissioning with government and non-government partners.
Conclusions: Chronic pain has been classified as a disease in itself through the World Health Organization. PHNs recognising chronic pain as a distinct condition in PHN needs analysis and data collection would lead to more dedicated funding. PHNs could do more to improve the secondary prevention and management of chronic pain. A self-identified need for greater collaboration across PHNs and co-commissioning with local and state governments and non-government partners would help to build PHN capacity.
Keywords: chronic disease, chronic pain, delivery of health care: integrated, health services: accessibility, health services: needs and demands, implementation, primary health care, secondary prevention.
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