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July 16, 2014

Advancing Telecare for Pain Treatment in Primary Care

Author Affiliations
  • 1Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City
  • 2Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), at the Iowa City VA Medical Center, Iowa City, Iowa
  • 3Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City
  • 4Institute for Clinical and Translational Science, University of Iowa, Iowa City
JAMA. 2014;312(3):235-236. doi:10.1001/jama.2014.7690

Chronic musculoskeletal pain accounts for an estimated 60 million ambulatory care visits in the United States each year and significantly impairs quality of life.1,2 Management of chronic musculoskeletal pain is frequently frustrating, both for patients and for their primary care physicians. Underrecognition and undertreatment of chronic pain have led to routine measurement and documentation of pain as “the fifth vital sign” as well as efforts to increase awareness of pain symptoms among clinicians.3 However, in the absence of effective systems for implementing evidence-based approaches for treating chronic pain, improved awareness of pain has resulted in increased and sometimes indiscriminate prescribing of chronic opioids, with harmful effects.4 Because of the high prevalence of chronic pain and the limited capacity of specialty pain clinics, effective interventions are needed that can be safely and widely implemented by primary care practices.

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