Increasing the Capacity for Delivering Interdisciplinary Pain Management in Southeast Asia: A Model for Lower Resource Regions

Despite strong evidence of the impact of pain burden globally, there is a mismatch between burden and resources for improving access to effective pain management services. This mismatch is especially evident in low resource countries. While there is often access to unimodal therapies, such as nerve blocks and drugs, they are of limited value in easing the burden of persisting pain experienced by patients and their communities. Without the necessary training and support, the vision of more comprehensive services will remain unrealized.

This workshop will describe and discuss what has been learned from a recently completed IASP supported project in Southeast Asia aimed at piloting a supervised training course to create local comprehensive multidisciplinary pain centers in three countries as a first step towards the development of a network of multidisciplinary pain clinics in each country. This training program involved the development of a ‘pain toolkit’ by experts from the region, supported by key international experts. The toolkit was peer-reviewed by experienced IASP members, and its implementation was tested within a competency framework in face-to-face and online workshops with local clinical leaders in pain management in each of the three countries (Myanmar, Indonesia, and Vietnam).

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The IASP Multidisciplinary Pain Center Toolkit Project

The talk will describe the IASP Multidisciplinary Pain Center (MPC) Toolkit Project including the impetus for the project and the aims of the project. The content of the IASP MPC Manual and the process of its development will be described, with emphasis on the training component, including the need for all members of the interdisciplinary team to understand the biopsychosocial model of pain, and be able to teach basic self management skills to patients with chronic pain.

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Developing a Generic Pain Self-Management Course for Multidisciplinary Health Care Providers using a Competency-Framework

This presentation will describe the pain self-management components of the toolkit training course. The presentation will outline how the clinicians were taught to engage patients in adopting a self-management approach, to build a therapeutic alliance, and to shift their focus from pain relief to achieving functional goals and greater self-reliance despite their persisting pain. Each session was designed to introduce specific skills that the participants were encouraged to practice during and between sessions to achieve competence in each. The final session included an assessment of levels of competence reached and recommendations for more advanced training. Excerpts from the toolkit training manual and associated homework tasks for the clinicians will be presented, as well as the patients’ workbook that the clinicians were encouraged to use during the course.

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Managing Cultural and Language Barriers in Delivering Pain Self-Management Skills Training to Health Care Providers from Low Resource Countries

While the concept of self-management has become established amongst healthcare providers (HCPs) in Western countries, it is relatively new in Southeast Asia. Furthermore, teaching patients how to use pain self-management strategies requires skills that may be unfamiliar to HCPs who have been trained in using mainly biomedical modalities in managing patients with chronic pain. Apart from getting the “mind shift” to start employing a more biopsychosocial approach, the Covid-19 pandemic restrictions meant that we had to deliver the interactive skills training using an online platform rather than the intended in-person training originally planned. As the training was focused on skills rather than knowledge alone, the educational model used required active participation by the trainees using a mix of role-plays, video demonstrations, home practice of the skills between sessions, and discussions. An additional challenge was that many of the participants from Indonesia and Vietnam had limited proficiency in English, and this meant translators were required to assist in ensuring the participants were able to comprehend the training and discuss their experiences with the facilitators. This session will highlight the main challenges faced in conducting the training with HCPs from different cultural and language backgrounds and how we tried to overcome these.

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Indonesian Participation in the Multidisciplinary Pain Clinic Toolkit Project and Pain Self-Management Skills Training for Health Care Professionals

Global Burden of Disease data has shown that chronic persistent pain is a condition that significantly contributes to disability in Indonesia. Many studies also show that chronic pain has a significant influence on functional outcomes. However, nationally, this fact has not received the attention it deserves. This is also reflected in health services which view pain as only a symptom, not seeing it as a specific health problem that does not only affect biological but psychosocial aspects. According to the current regulations, pain services are mainly carried out by doctors and the role of other health professionals is not very specific. For this reason, a breakthrough is needed to raise awareness of the importance of services using team approach to dealing with pain with its biopsychosocial aspects. This presentation will describe the backgrounds why Indonesia need to implement multidisciplinary pain service, the challenges and opportunities, Despite the absence of a system that supports its implementation. The efforts to introduce this concept involving all health care professionals started by introducing pain self-management skills  using biopsychosocial model (doctors, nurses, psychologist, and physiotherapist) from several top referral hospitals in Indonesia will also be described.

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Health Professionals’ Pain Management Education – Strategy to Action Through Partnership and Engagement

Health professionals pain management education and training is underpinned by the aim of improving the care and lives of people living with pain. To attain this goal, education initiatives need to sit within a broader strategic framework; readily translate into practice in an appropriate and sustainable way; achieve set outcomes; and have positive impact within communities. Authentic ‘partnership and engagement’ with key stakeholders including people with lived experience is critical from strategy / initiative development to implementation to success.
This interactive workshop aims to engage participants in exploring and applying a partnership and engagement framework to maximise the impact of their own educational initiatives / research.

The workshop team will share learnings from three novel pain education initiatives in Australia and Canada:
1. Development of a national pain management education implementation strategy for health practitioners;
2. A novel empirically-derived framework to strengthen national interdisciplinary pain training, and,
3. Development and implementation of an interfaculty pain curriculum for prelicensure trainees that incorporates multistakeholder needs.

Working with guided small group activities, the team will facilitate application of a partnership and engagement framework within the participant’s own interprofessional context. Worksheets with a guide and enduring record of activities, will encourage reflection and analysis.

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The Australian Experience Developing a National Pain Management Education Strategy for Health Professionals

A/Prof Meredith Craigie will outline Australia’s approach to improving pain care for all Australians over a twelve-year period.   Following the National Pain Summit held in Canberra, Australia in 2010, a National Pain Strategy was developed to raise the profile of pain from multiple perspectives including advocacy for people with lived experience of pain through to service provision and pain education.  Strong advocacy from Pain Australia and multiple health professional organisations led to the Australian Government funding development of the 2019 National Strategic Action Plan for Pain Management.   Further funding has enabled the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists to lead the National Pain Management Education Strategy for Health Practitioners project.  This presentation will focus on the need for developing a national strategy first, engaging with multiple stakeholder groups from the high levels of government, to regulators, tertiary educational institutions through to educators and clinicians, engaging with learners and people with lived experience of pain to develop the strategy and ensure its implementation.
Key insights from the Australian experience of putting strategy into action will inform the facilitated round-table discussions following the presentations.

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A Partnership Approach to Strengthen the Pain Training of Health Professionals in Australia

This presentation will outline outcomes from a novel priority setting partnership (PSP) project funded by the Australian Government. The PSP was undertaken in collaboration with people living with chronic pain, carers and health professionals working in pain care in a genuine effort to empirically-derive a person-centred interdisciplinary pain training framework. The ‘Listen to me, learn from me’, framework repositions health workforce training through this partnership lens, with the aim of strengthening training efforts to support high-quality person-centred pain care. The framework is underpinned by 9 training domains, (with 44 specific pain care priorities) with training targets including, empathic validation; effective, respectful, safe communication; ensuring genuine partnerships in co-planning personalised care. This framework is intended as a blueprint to shape Australian interdisciplinary health workforce training with the overall aim of providing better high quality person-centred pain care. The partnership approach to implementation will be discussed, highlighting how the interdisciplinary pain training will be scaled up and how sustainability will be addressed using a digital ecosystem designed for this purpose.

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The Interfaculty Pain Curriculum at the University of Toronto

Will highlight the importance of incorporating patient-oriented and interprofessional pain education into pre-licensure health professions student education, sharing reflections on 20 years of delivering the Interfaculty Pain Curriculum (IPC) at the University of Toronto.

The IPC brings together more than 1000 students from eight health professions for 20 hours of multimodal training to address a persistent need for interprofessional care for pain. Curricular objectives mirror those of the International Association for the Study of Pain Interprofessional Pain Curriculum.  Coordinators, faculty, facilitators, and evaluators reflect the interprofessional nature of the curriculum, which includes people living with pain.


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