Enhancing outcomes for people with chronic pain

An estimated 3.24 million Australians are affected by chronic pain with this number projected to rise to 5 million people by 2050 due to an ageing population and rising prevalence of chronic conditions.¹ Good pain management can positively support a person’s quality of life, allowing people to work or study and participate in the community. Best practice for chronic pain management involves a person-centred, holistic and interdisciplinary approach to care with a focus on self-management.¹

Despite limited evidence for the efficacy or safety of medications in chronic pain, there has been an overall significant increase in their prescription in the years prior to 2016-17.² Since then, rates of opioid prescription have declined. Data from the PBS indicates that in 2021-22, around 13.3 million opioid scripts were dispensed to 2.9 million patients for pain relief with rates of dispensing highest in inner region and outer regional areas.²

This activity focuses on providing better care for people with chronic pain by strengthening interdisciplinary support and avoiding over-reliance on medications. And aligns to the updated MyMedicare Chronic Conditions Management (CCM) Framework.

Setting a goal

Improve the quality of life for people with chronic pain by providing appropriate management and treatment strategies.

Resources to support your QI

To achieve this goal, you can access a range of resources:

Review current best practice:
- The National Strategic Action Plan for Pain Management sets out key priorities to improve best practice pain management.
- RACGP Guidelines for Pain Management include information on the appropriate prescription of opioids.
HealthPathways: Explore locally tailored approaches for pain management. Simply enter “Pain Management” or “Deprescribing” in the search bar to get started.
Pain Australia is a peak advocacy body for people living with pain and provides a range of resources for consumers and healthcare professionals.
NPS Pain Management Hub provides a range of resources including information on opioid deprescribing.

Bringing the team together

Kickstart your quality improvement activity by bringing together a quality improvement team. Together, you’ll identify the key challenges and come up with innovative solutions, ensuring you all share a clear understanding of the improvement objectives and strategies.

Engage with your Primary Health Coordinator from CCQ; they can offer tailored support, resources and guidance to enhance your QI efforts wherever you are in your QI journey. Your Primary Health Coordinator can support your practice to:
- Bring a QI team together to decide on an improvement idea
- Plan, start and finish a QI activity
- Facilitate QI meetings
- Create practice-wide systems improvements that align with the updated CCM Framework.

Gather data and information. Review current practice data and processes for managing patients with chronic pain.
Identify and discuss any common barriers to optimal pain management strategies. Consider using process maps, flow charts or driver diagrams to generate change ideas and improve processes.

Maximising your data

What data might you need? You’ll need data to understand the problem and measure your outcomes. We suggest you start with:

Primary Sense can provide insight, detailed reports and targeted guidance on improving data quality. The Medication Safety Alert “Prescribing a fentanyl patch where there is non-cancer pain” is a useful alert to consider.
Conduct a search on your practice software for patients prescribed Narcotics/Opioids.

Improvement ideas for inspiration

To achieve your goal, you can consider several possible improvement ideas such as:

Conduct a practice education and training session on chronic pain management.
Increase home medicines reviews for patients on long-term opioids.
Increase the number of Chronic Condition Management Plans and timely reviews for patients with chronic pain, in line with MyMedicare CCM framework changes.
Identify patients prescribed long term opioids for non-cancer pain and flag for deprescribing.
Review actions for the Primary Sense Medication Alert ‘Prescribed a fentanyl patch where there is non-cancer pain’ and add a note on the patient file to conduct appropriately timed medication review.
Develop a process to consistently clinically code in your practice software where a patient is identified having chronic pain.

Remember to self-report your QI project as a CPD activity. QI is a great tool for measuring tangible outcomes and demonstrating improvement in patient care!

Share your results with your CCQ practice support team and with your patients. Ensure you document your quality improvement activity to meet PIP QI guidelines and for CPD purposes.

References

Commonwealth of Australia. National Strategic Action Plan for Pain Management. Department of Health, Disability and Ageing; 2021.
Australian Institute of Health and Welfare (2024) Alcohol, tobacco & other drugs in Australia, AIHW, Australian Government, accessed 28 January 2025.

Ready to begin this QI activity?

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