Suboptimal care and inappropriate opioid use in chronic pain: A critical analysis of two case studies and healthcare expenditure burden

Sarah Al-Samawy; Anne Burke; Tim Semple; Jacinta Johnson

doi:10.5055/jom.0868

Authors

Sarah Al-Samawy, BPharm (Hons) https://orcid.org/0000-0002-1571-5709
Anne Burke, BSc (Hons), MPsych (Clin), PhD
Tim Semple, MBBS
Jacinta Johnson, BPharm (Hons), PhD, AdvPracPharm https://orcid.org/0000-0003-4786-022X

DOI:

https://doi.org/10.5055/jom.0868

Keywords:

inappropriate opioid use, chronic pain, pain management, risk mitigation, nonpharmacological interventions

Abstract

Introduction: Chronic pain is a leading cause of chronic disease in Australia, with a 2020 report indicating that one in five Australians aged over 45 experience chronic pain. The high prevalence of chronic pain accounts for significant healthcare utilization and associated costs, with the economic impact of chronic pain estimated to be AUD$139 billion in 2018.

Case presentations: This paper uses two exemplar cases to demonstrate inadequacies within the current systems supporting those with chronic pain and the associated impacts these inadequacies have on patient outcomes and healthcare costs.

Management and outcome: An analysis of these cases demonstrated a combined healthcare cost of AUD$312,705 throughout their inpatient admissions, with no apparent benefit to either patient's pain experience.

Discussion and conclusion: These cases highlight a multitude of opportunities to improve current pain management systems and their detrimental effects on patient well-being, healthcare utilization, and associated costs. Despite massive expenditures for the management of chronic pain, patients often continue to experience ongoing pain and reduced quality of life. This indicates that the available funds could be better utilized through reallocation to support a proactive, biopsychosocial model of care for the prevention and management of chronic pain.

Author Biographies

Sarah Al-Samawy, BPharm (Hons)

Westmead Hospital, Sydney, Australia

Anne Burke, BSc (Hons), MPsych (Clin), PhD

Associate Professor, Central Adelaide Local Health Network, Adelaide, Australia

Tim Semple, MBBS

Royal Adelaide Hospital, Adelaide, Australia

Jacinta Johnson, BPharm (Hons), PhD, AdvPracPharm

SA Pharmacy, Government of South Australia, Adelaide, Australia

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