Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #99849

Etienne J. Phipps, PhD¹, Judith Quinn, RN, MSN², William Tester, MD, FACP³, Joann Ackler, BS, RN³, Nora Madison-thompson, BA², and Sherry Pomerantz, PhD⁴. (1) Einstein Center for Urban Health Policy and Research, Thomas Jefferson University, Albert Einstein Healthcare Network-Germantown Community Health Services, 1 Penn Blvd, Philadelphia, PA 19144, 215-951-8137, phippst@einstein.edu, (2) Center for Urban Health Policy and Research, Albert Einstein Healthcare Network, One Penn Blvd., Wister Tower Suite 4442, Philadelphia, PA 19144, (3) Cancer Center, Albert Einstein Medical Center, 5501 Old York road, Philadelphia, PA 19141, (4) School of Osteopathic Medicine, Department of Medicine, University of Medicine and Dentistry of New Jersey, One Medical Center Drive, Stratford, NJ 08084

The management of pain is inadequate and problematic for many cancer patients. While there are policies and practices in place to support the assessment and treatment of pain, there are patient, provider, insurer, and industry barriers that make satisfactory pain control illusive for many patients. This policy-focused presentation is based on multiple data sources—the patient, the medical record, the pharmacy, and pharmaceutical company ‘safety net' programs. Patient level data were collected from low to moderate income ambulatory cancer patients (n=40) who reported being in moderate to severe pain. The patients were seen at a large teaching hospital and healthcare delivery network located in North Philadelphia, where one quarter of the population live below the federal poverty level. Patients' reports of financial difficulties, fears of addiction and other beliefs about the use of pain medication contributed to the undermanagment of the patient's pain. We also investigated pharmaceutical ‘safety net' programs regarding parameters for enrollment and procedures for receipt of pain medications. Investigation into pharmaceutical ‘safety net' programs revealed an additional set of barriers for low income patients, from processing procedures to exclusion criteria. The implementation of cost effective pain protocols poses additional challenges, including patient resistance and the need for more intense monitoring. The importance of integrating data from the difference sources to improve evidence-based policies and practices in the management of pain is highlighted.

Learning Objectives:

• Identify 3 limitations of pharmaceutical safety net programs for pain medications.
• Analyse the health policy implications for the treatment of patients with cancer
• Identify 3 interventions with patients whose financial barriers are associated with inadequate pain control.

Keywords: Health Care Access, Practice-Based Research

Related Web page: www.einstein/edu/urbanhealth

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation