News Briefs: AMA, JCAHO, NCQA create pain management project

Three of the nation’s leading professional organizations in the health care field are teaming up to develop a common set of evidence-based measures for evaluating the appropriateness and effectiveness of pain management for patients suffering from cancer, back pain, and arthritis.

The two-year project, sponsored by the American Medical Association (AMA) in Chicago, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in Oakbrook Terrace, IL, and the National Committee for Quality Assurance (NCQA) in Washington, DC, will help physicians, health plans, hospitals, and other health care organizations determine how well they are doing managing patients’ pain.

The initiative represents a major effort to improve the quality and consistency of pain management across the country. The March 2001 Institute of Medicine report, "Crossing the Quality Chasm," identified back problems, arthritis, and cancer among 15 therapeutic areas prioritized for improvement in care.

in the coming months, AMA, JCAHO and NCQA will convene a panel of practicing physicians, pain management experts, and performance measurement experts that will define important aspects of pain management that should be measured. The panel then will develop a set of standardized pain management performance measures. The final phase of the project will involve testing the measures across multiple-care delivery settings.

The resulting measure set will be designed to give physicians, health plans, hospitals, and other provider organizations consistent messages about the important aspects of pain management and will help to identify opportunities for improving the quality of care provided to these patients. The AMA, JCAHO, and NCQA also are committed to working together to reduce duplicative data collection activities that are burdening a health care system already beleaguered with rising medical costs.

"Unrelieved pain has profound physiological and psychological consequences that result in significant costs to patients and families, to the health care system, and to society as a whole," says Yank D. Coble Jr., MD, president-elect, AMA. "Unfortunately, a variety of barriers impede the use of appropriate treatments, causing many patients to suffer needlessly. We have an important opportunity here to provide relief for patients by promoting consistency and quality in the management of pain."

"Pain is the most common reason that patients seek medical care, yet we don’t always know whether the treatments provided are effectively meeting patient needs. This must change," says Dennis S. O’Leary, MD, president, JCAHO. "Working together, I am confident that we can make significant strides in addressing this serious public health issue."

"One of the major precepts of caring for patients is to always strive to relieve pain and suffering," says Greg Pawlson, MD, executive vice president, NCQA. "These measures will help us quantify how we’re doing in that area, while at the same time driving improvement in the care delivered to a large, diverse patient population."

The AMA, JCAHO, and NCQA have worked together to coordinate performance measurement development activities since 1998, and earlier this year unveiled Coordinated Performance Measurement for the Management of Adult Diabetes — a new approach to measuring performance in the delivery of care to diabetes patients.

Purdue Pharma in Stamford, CT, is providing unrestricted funds to support development of the pain management measure set. Control and responsibility for the design and content of the measure set rest solely with the AMA, JCAHO, and NCQA. JCAHO will function as the administrative center for the project.