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Symposium Overview
The extent and implications of chronic pain in the lives of Canadian Armed Forces (CAF) Veterans and their families are significant. This CIMVHR symposium brings together experts and Veterans with lived lives from Canada and the United States to share leading edge developments. Dr. Eric Schoomaker, 42nd U.S. Army Surgeon General and former Commanding General of the U.S. Army Medical Command will open the symposium with a reminder about the important roles of emerging interdisciplinary approaches to managing chronic pain. Dr. Friedhelm Sandbrink, national program director for pain management for the U.S. Veterans Health Administration, will describe lessons learned from the U.S. Departments of Defence and Veterans Affairs in the prevention and treatment of chronic pain employing a stepped care approach that engages primary care. Dr. Ben Kligler, Director of the Office of Patient Centered Care & Cultural Transformation in the U.S. Veterans Health Administration will describe the “whole health” approach to enhancing well-being, including the biopsychosocial management of chronic pain with the integration of complementary practices and conventional modalities. Dr. Ramesh Zacharias, President, CEO and Medical Director of the Chronic Pain Centre of Excellence for Canadian Veterans will describe the advances being made in Canada. Finally, a panel moderated by Dr. Schoomaker including a Veteran with lived experience will carve the pathway forward.
Learning objectives:
- Become aware of the sheer size and extent of the problem across military and Veteran populations.
- Incorporate an interdisciplinary, biopsychological, person-centered approach to managing chronic pain.
- Shift cultural attitudes to acute and chronic pain.
- Foster development of a inter-professional stepped care approach to prevention and management of chronic pain within and beyond health care.
View the full symposium here
Moderator and Presenters
In order of appearance
Agenda
Chronic pain
Comprehensive Person-Centred Pain Management: Common Themes and the Way Forward
Opening Remarks
David Pedlar, PhD, Scientific Director, Canadian Institute for Military and Veteran Health Research
Eric B. Schoomaker, MD, PhD, Lieutenant General, U.S. Army (Retired); 42nd U.S. Army Surgeon General and Former Commanding General of the U.S. Army Medical Command
The US VA’s Experience with Biopsychosocial Pain Management
Friedhelm Sandbrink, MD, National Program Director for Pain Management, Specialty Care Services; and Veterans Health Administration, Director Pain Management, Dept of Neurology, VAMC
The Veterans Health Administration (VHA) in the US Department of Veterans Affairs employs a Stepped Care Model for Pain Management that is firmly rooted in biopsychosocial pain care. Foundational is self-care/self-management utilizing VHA’s Whole Health approach. Most Veterans receive their pain care within their “Patient-aligned Care Teams”, i.e. Primary Care teams with integrated mental health providers and access to multimodal pain care. Since 2017, all VHA facilities are mandated to have Pain Management Teams/Pain Clinics offering interdisciplinary pain specialty care including medical management, opioid use disorder treatment, behavioral therapy and rehabilitation modalities, and supported by a network of interdisciplinary pain rehabilitation programs. The session will also discuss multiple examples for team-based collaborative pain care that coordinates across program lines to improve Veterans quality of life and safety.
Q&A moderator: LGen (Retd) Eric B. Schoomaker
Whole Health Approach in the VA: An Example of a Biopsychosocial Model
Benjamin Kligler, MD, MPH, Executive Director, Office of Patient Centered Care & Cultural Transformation, US Veterans Health Administration
This session will describe the whole health approach being implemented in the Veterans Health Administration in the US as an exemplar of a biopsychosocial, stepped care approach to pain. Outcomes from the first 18 VA medical centers to fully deploy this approach will be discussed.
Q&A moderator: LGen (Retd) Eric B. Schoomaker
Canadian Perspective on Pain Management in Canadian Veterans
Ramesh Zacharias, MD, FRCS (C), CEO and Medical Director, Chronic Pain Centre of Excellence for Canadian Veterans; Assistant Clinical Director, Department of Anesthesia, Faculty of Health Science, McMaster University Medical Centre
This presentation will detail the historical and current landscape of chronic pain in Canadian Veterans. This will include details on the emergence of person-centred approaches and interdisciplinary treatments for chronic pain management.
Over the years, the approach to pain management has shifted from injections and medications to a person-centred, holistic approach to include physical, psychological, medical and complementary therapies. While many programs provide interdisciplinary treatments, they vary in duration, disciplines involved and level of comprehensive integrative pain management. This presentation will showcase the interdisciplinary pain program at the Michael G. DeGroote Pain Clinic at Hamilton Health Sciences. Michelle Bourdon, who completed this program, will share her positive experience through a touching testimonial.
The evidence around the use of cannabis in treating Veterans with chronic pain will also be presented.
Q&A moderator: LGen (Retd) Eric B. Schoomaker
Panel – Where do we go from here?
Moderator: LGen (Retd) Eric B. Schoomaker
Panelists: Dr. Friedhelm Sandbrink, Dr. Ben Kligler, Dr. Ramesh Zacharias and Pte (Retd) Michelle Bourdon
Closing Remarks
LGen (Retd) Eric B. Schoomaker
David Pedlar, PhD