FOCUS on chronic pain

Chronic pain is a common and debilitating condition affecting up to one fifth of the Australian population. Chronic pain creates burdens on healthcare professionals, patients, carers and clinical resources and results in significant lost productivity. A recent strategy to address chronic pain is the introduction of a global educational program called FOCUS. This aims to enhance general practitioners’ insight and knowledge of chronic pain and its management.

In 2007, over 1000 Australian general practitioners attended the FOCUS workshops held in Australia. More than 90% of them considered FOCUS relevant to their practice, and 94% said the presentation content was useful.⁴

Pain is broadly defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Chronic pain may be defined as pain occurring beyond the expected time of healing or for greater than three-six months. It is typically persistent, unpredictable and may be associated with depression, fatigue and impaired physical and mental performances.

Chronic pain is a common and serious problem for Australian patients and carers. In 2007, around 3.2 million Australians (1.4 million males and 1.7 million females) were estimated to experience chronic pain.⁵ These figures exceed Australian prevalence rates for other long-term conditions, including hypertension, asthma and high cholesterol. The incidence of chronic pain is particularly high in older age brackets and may impact on activities of daily living.

It is estimated that chronic pain will affect 5 million people in Australia by 2050.⁵

Chronic pain creates substantial financial and social burdens on the Australian community. It leads to an independent increase in the use of health services and causes substantial economic costs in terms of lost productivity. The latter includes both absenteeism and reduced effectiveness for employees who continue to work in pain (presenteeism). Access Economics estimated the total cost of chronic pain in Australia in 2007 at $34.3 billion. The cost per person with chronic pain was estimated at $10,847 in 2007.⁵

Despite the high prevalence and significant burdens of chronic pain, appropriate management strategies are not well developed. General practitioners are often burdened with the treatment of chronic pain due to the lack of pain clinic resources and long waiting lists. Chronic pain treatment is complex and may involve a combination of analgesics, lifestyle changes and adjuvant treatments including physical and psychological therapies. Unfortunately, however, many patients remain untreated or turn to self-medicating to relieve their suffering.

Fortunately a global education program called FOCUS (standing for Focus on Outcomes in Chronic pain through Understanding and practical Solutions) has been developed to address some of these issues. Originally developed in the United Kingdom, the FOCUS workshop allows general practitioners to enhance their knowledge of chronic pain and devise appropriate multidisciplinary management strategies.

As a result of attending a FOCUS meeting last August, a Western Australian general practitioner said:⁴ "[I am now]…better able to assess patient’s pain, better able to choose appropriate analgesia, better able to counsel patients about effects and side-effects of [pain] medication."

The program, conducted over dinner, includes 1.5 hours of interactive presentations, shared experiences and case based discussions, specifically targeted to general practitioners. Participants are awarded 3 RACGP Category 2 CPD points and 1.5 ACRRM PD points for attending.

The FOCUS program is interactive, succinct, comprehensive, practical and highly recommended for Australian general practitioners. Hopefully this unique program will promote insight into chronic pain, improve treatment strategies, and reduce the discomfort and disruption experienced by chronic pain sufferers.

Dr Roger Goucke, Medical Director of the Virtual Pain Centre and Consultant in Pain Medicine said, "This FOCUS program from Janssen Cilag provides a useful educational template for a discussion on the management issues that must be addressed in the dialogue between general practitioner and patient.

"A wide range of non drug and drug based therapies can be covered and a plan suitable for the individual patient developed. I would strongly recommend this type of program for General Practitioners to use in group based discussion."

Source:

Australian Institute of Health and Welfare 2006. Australia’s health 2006. AIHW cat. no. AUS 73. Canberra: AIHW.
Blyth FM et al. Pain 2001; 89: 127-34.
Van Leeuwen MT et al. Chronic pain and reduced work effectiveness: The hidden cost to Australian employers. Eur J Pain 2006: 10:161-66
FOCUS: Chronic Pain Solutions. [brochure] 2008. Janssen-Cilag. Available from URL: /uploads/VMC/DrugImages/
2019_JAN0080_Focus_Card_V11.pdf
The high price of pain: the economic impact of persistent pain in Australia. Access Economics 2007. Available from url: http://www.accesseconomics.com.au/publicationsreports/showreport.php?id=142