Patient-Centered Chronic Pain Journey Map Issued by Opioid Collaborative

Every day, an estimated 130 Americans die from an opioid overdose—a bleak statistic that has devastated families and communities across the nation.  According to the National Academy of Medicine (NAM), due to the complex and urgent nature of this epidemic, reversing the opioid crisis “will require a multi-sectoral and multi-pronged response; no organization, government agency, or sector can solve this crisis on its own.”

To improve coordination and to accelerate the pace of change, NAM has partnered with the Aspen Institute and more than 60 organizations across different sectors to form the Action Collaborative on Countering the US Opioid Epidemic, which represents critical stakeholder groups across public, private, and nonprofit sectors. Rodrigo Garcia MSN, CRNA, MBA and CEO of the Parkdale Center, serves on the Action Collaborative’s Persons with Lived Experience Advisory Group.

The Action Collaborative’s mission is to develop, curate, and disseminate solutions designed to reduce opioid misuse and improve outcomes for individuals, families, and communities affected by the opioid crisis.

In its most recent effort, the Collaborative has developed The Chronic Pain Journal Map for your patients.  The Map outlines 5 key stages in your patients’ pain management journey and visually illustrates their experiences in living with chronic pain as they navigate treatment and care systems.

The genesis of the chronic pain map

The Collaborative conducted surveys and a series of listening sessions with individuals living with pain and those clinicians who treat pain to better understand the current state of chronic pain management.

The 5 key stages are presented from the perspective of individuals living with chronic pain and who have described what works well, along with their common challenges.

“Most importantly, the Journey Map is a tool that can be used to not only identify critical gaps in chronic pain care, but also highlight opportunities to develop needed tools, resources and/or initiatives to address those gaps and transform chronic pain management,” said the Collaborative’s developers.

This new NAM resource highlights gaps in chronic pain care and the actions that can be taken to improve the pain management process.  Their tool, known as the Chronic Pain Journey Map, was informed by individuals with chronic pain and clinicians in pain management to understand the patient-clinician experience when navigating treatment.  According to NAM, if adopted, the actionable strategies outlined in the map “can accelerate a range of pain treatments by outlining approaches to effective communication that lead to strong clinical relationships and strategies to prioritize the quality of life for people with pain.”

The 5 key stages

The journey map is a visual illustration whose purpose is to describe the varied experiences of your patients living with chronic, non-cancer, and other types of pain experiences.  Specifically, it identifies 5 key stages of the journey that have critical touchpoints with the health system in which you practice.  Each stage of the journey is framed from the perspective of patients’ lived experience and details what worked well for them as well as the common shortcomings and challenges they experienced.

The journey map also identifies actions that you as a clinician can take to improve the pain management process.  Each stage also provides helpful resources intended to improve your patients’ pain management journey.

How did it come about?

The Action Collaborative on Countering the US Opioid Epidemic conducted listening sessions and gathered survey data from people living with pain and those clinicians who treat pain in order to better understand their current chronic pain management approaches.  Next, the data was analyzed to identify key themes and was summarized in an assessment report.  The insights from this work then led to the creation of this person-centered chronic pain journey map.

It started with listening

The tool is based on the clinical findings and reportage of patients’ lived experience and its developers hope that its highlights can be used to improve chronic pain care, and ultimately lead to optimal quality of life for your patients living with pain.  The journey map tool can be used to not only identify gaps in chronic pain management, but also to highlight opportunities to develop tools, resources, and initiatives to address those gaps and transform your approach to chronic pain care.

Its developers hope to reach providers “who are committed to understanding and improving the chronic pain management process.”

To access or to download the chronic pain map

An interactive web-based version of the journey map can be accessed here.  In addition, the interactive journey map is also accessible via your mobile device.  NAM has also provided this instructional video to aid in navigate this tool.

In addition to the Map, NAM has provided a plethora of supplementary clinician resources for you here:

Education and training resources for you

• Pain Education Toolkit
• Pain Management Best Practices
• Chronic Pain Treatments
• Opioid Overview for Healthcare Providers
• Interactive Trainings for Prescribers- Applications of the 2016 CDC Guideline
• Videos on Improving Communication About Prescription Opioids
• Posters for Patients and Providers – Opioids
• Video Library: Pain Management Learning Hub

Clinical Assessment and Evaluation Tools

• Pain Management Toolkit (all clinicians)

Assessment, Referral, and Education Tools

• Education and Training for Physicians – Core Pain Curriculum
• Patient-Facing Educational Materials
• Referral to a Pain or Addiction Specialist

Communication Resources

• Improving Pain Management and Opioids in Partnership with Families and Patients: Initial Questions to Ask

Care Team Collaboration

• Team-based/Collaborative Care and Collective Intelligence

Treatment Resources

• MME Calculator and Guidelines
• Checklist for Prescribing Opioids
• Clinical Tool for Prescribing Opioids

Multidisciplinary and Comprehensive Care Delivery

• Fact Sheet: Shared-Decision Making

Treatment Management Tools

• Guidance for Dose Reduction and Discontinuation of Opioids
• Case Study: Evaluating High-Risk Patients Treated with Opioids

Long-Term Pain Care

• Clinician Toolkit for OUD and Pain Assessments
• Guidelines for Chronic Pain Management

Research, Diagnostics, and New Treatments

• Video: Involving Patients as Equal Partners in Research

What only you can bring

CRNAs and other health care providers play an integral role in creating environments that invite, welcome, and support partnerships with patients and families confronting opioid-related recovery.  The NAM initiative is part of its mission to develop and provide training for clinicians to build skills for partnering with patients and families, to further familiarize providers with the lived experience of their patients, and to identify and address barriers to individuals in recovery—those patients who live with acute and chronic pain that is managed with opioids, individuals with active substance use disorder, and families of those affected.