We frequently hear news about the returning military troops and the health issues that they face following service in Iraq and Afghanistan. A large number of veterans experience pain on a regular basis and post-traumatic stress, traumatic brain injury, depression, and substance use tend to co-occur. Many nonmilitary people in the United States also struggle with these issues and there is an urgent need for research to identify strategies that are helpful, as well as identify strategies that may be in use that do not help with these problems.
The Office of The Army Surgeon General’s Pain Management Task Force released their Final Report in May 2010: “Providing a Standardized DoD and VHA Vision and Approach to Pain Management to Optimize the Care for Warriors and their Families” [3.66MB PDF]. The U.S. Department of Defense and Department of Veterans Affairs have launched a Comprehensive Pain Management Campaign Plan. One of the objectives specified in the final report and the campaign is to incorporate complementary and integrative therapeutic modalities into patient-centered plans of care.
In a separate effort, the 2011 Institute of Medicine Consensus Report—Relieving Pain in America encourages acceleration of collecting data on pain incidence, prevalence, and treatments. This report notes that, ideally, most patients with severe persistent pain would obtain pain care from an interdisciplinary team using an integrated approach that would target multiple dimensions of the chronic pain experience.
Research on pain management is identified as a high priority in NCCAM’s Third Strategic Plan (2011–2015). With the implementation of the Comprehensive Pain Management Campaign Plan, researchers have an opportunity to study utilization and outcomes associated with the use of complementary approaches in real world settings.
NCCAM is very interested in encouraging research in military and veteran populations. Potential areas of focus could include:
- Mining of large data sets from electronic health records
- Efficacy, effectiveness, or the implementation of complementary approaches to pain management
- Identification of mechanisms by which approaches could have effects.
On June 1, NCCAM’s National Advisory Council approved a concept for the development of initiatives to encourage research on the use of complementary approaches for the management of pain and associated problems (e.g., post-traumatic stress disorder, traumatic brain injury, depression, anxiety, sleep disturbances, substance abuse) among U.S. military personnel, veterans, and their families. While possibilities for conducting pragmatic research and using information from electronic health records are interesting and the publications that could potentially result from such research would be exciting, at the end of the day it is really all about reducing pain and suffering and enhancing resilience.
What are your thoughts?