Primary care
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Chronic pain is a common presenting problem in primary care offices. Primary pain disorders and chronic pain secondary to another underlying medical problem can significantly impact a patient's function and quality of life. ⋯ Through thorough patient interview, physical examination, diagnostics, and standardized assessment tools, primary care clinicians can create a robust care plan for patients with chronic pain. Given the multifaceted nature of chronic pain, it is a diagnosis that fits into chronic disease model of care managed appropriately in the primary care setting.
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Chronic pain is a significant public health concern. Care for patients with chronic pain is complex and involves many intersecting systems, policies, and procedures. Applying systems engineering concepts to chronic pain management opens the door to addressing a wide range of performance gaps through a structured, evidence-based approach. Successful implementation of systems-based practice includes effectively incorporating interprofessional teamwork, community resources, team-based care, patient safety, hospital readmissions, use of evidence-based medicine, transitions of care, and care for the underserved, including social determinants of health into the routine delivery of health care services including pain management.
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Pharmacologic management of chronic pain is one component of a patient-centered care plan. Multiple classes of medications are available and can be used individually or in combination. Choice of medication is determined by the type and cause of pain, safety profile of the medication, patient values and preferences, comorbid conditions, cost, and availability. Incorporating shared decision making is critical when implementing a pharmacologic pain management regimen.