Acute Pain Management at the Intersection of Primary and Secondary Care: Insights from Recent Literature.
Shouq S AlGhamdi, Dalia M Aljohani, Rosalind Adam, Patrice Forget
Abstract
Open AccessAcute pain is a significant clinical challenge in primary and secondary care. If inadequately managed, acute pain is a major risk factor for the development of chronic postsurgical pain and persistent postoperative opioid use. In this perspective article, we offer the authors' viewpoints informed by selective literature with the aim of helping identify avenues to improve the quality and safety of acute pain management. Current evidence in the quality and safety of pain management shows that the role of primary care staff in education, follow-up, and tapering remains largely unaddressed, while patient perspectives and experiences reveal gaps in communication, stigma, and trust. Screening tools, guidelines, and strategies to reduce variations in the prescription and use of opioids remain inconsistently developed. In conclusion, if pain is multifaceted and should be approached in a multidisciplinary way, strong integration between primary and secondary care is essential. Communication with primary care, tapering, or referral should be facilitated. Patient experience should receive more attention, and future studies should focus on implementing guidelines and multidisciplinary guidance, as well as providing continuous feedback to clinicians on their practice and outcomes.