Volume 4, February 2010
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According to the National Center for Health Statistics, approximately 76.2 million Americans suffer from chronic pain — more individuals than are affected by diabetes, heart disease, and cancer combined. The numerous causes of chronic pain include low back problems, headache, migraine, and arthritis. Chronic pain can also be caused by diseases or disorders such as fibromyalgia, cancer, and neuropathic pain.
Added to this burden is the high prevalence of those suffering from chronic pain who go on to develop substance abuse — most commonly with prescription pain medications within the classification of drugs referred to as opioids used to treat acute pain or chronic cancer pain.
The abuse of prescription drugs is a serious and growing health problem in the United States. Recent data indicate that prescription drug abuse, with emphasis on opioid pain killers, has increased at an alarming rate over the past decade. Statistics published in the National Survey on Drug Use and Health (NSDUH) by the Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), demonstrate that prescription drugs account for the second most commonly abused category of drugs, surpassing cocaine, heroin, and methamphetamine.
Also supporting this data are findings of a 2009 study published in the Mayo Clinic Proceedings which report that chronic pain and prescription opioid abuse are highly prevalent and exact an enormous toll on patients, physicians, and society. As part of the solution, the study recommends that health care professionals begin to seek methods of balancing aggressive treatment of chronic pain with the careful need to minimize risks associated with opioid abuse.
Other classifications of prescription medications most commonly abused include: central nervous system (CNS) depressants such as tranquilizers and sedatives prescribed to treat anxiety and sleep disorders; and stimulants prescribed to treat ADHD and narcolepsy.
The annual cost of chronic pain in the United States, including health care expenses, lost income, and lost productivity is estimated to be $100 billion. When the cost of substance abuse is added to this equation, total costs reach a total of $198 billion.
Moreover, a recent study sponsored by the Institute for Health and Productivity Management (IHPM) found that employees with chronic pain were five times more likely to experience work limitations than those without chronic pain. Additionally, employees with chronic pain lost more than 3.5 work days per four day period as a result of reduced productivity caused by absenteeism and presenteeism.
To this end, researchers are searching for ways to improve the clinical management of chronic pain and significantly reduce patient risk. Additionally, they are working to find non-pharmacologic pain management tools to reduce the amount of pain medication needed to effectively manage chronic pain, including yoga, breathing exercises, and relaxation training.
Another effective solution is online Digital Health Coaching, particularly for the management of low back pain which affects more than 26 million Americans and is the leading cause of disability among those under age 45.
Health Plans and employers are turning to the HealthMedia® CARE™ for Your Back Digital Health Coaching program, which address risk factors associated with back pain to provide individually tailored prevention and management techniques for each participant. The program covers the following areas:
Kaiser Permanente, the nation's largest non-profit health plan, has selected HealthMedia® as the digital solution to provide over 8.2 million plan members with behavior change programs designed to improve their health. And, since chronic pain rarely exists in a vacuum, HealthMedia® offers programs to help with conditions which often occur with pain.
For example, across all of HealthMedia's book of business, we find that over 70 percent of those reporting chronic pain are also reporting with sleep issues — and over 80 percent indicated that they were either feeling depressed or had been formally diagnosed with depression. Kaiser Permanente plan members have the option of taking the HealthMedia® Overcoming™ Insomnia and HealthMedia® Overcoming™ Depression, as well as Digital Health Coaching programs for nutrition, physical activity, and stress reduction — offering them holistic solutions that have shown to be effective as a first step in helping reduce reliance on pain medications.
Participant self-reported results at 6 months. Productivity savings data was calculated using the Work Productivity Activity Impairment (WPAI) questionnaire, which employs a validated algorithm to generate an estimate of productivity impairment. The WPAI consists of questions about absence from work, hours actually worked, the reduction in productivity at work, and the reduction in productivity while performing regular activities. Productivity savings is calculated using an average annual salary and benefits package of $50,000.