This article was originally published by the University of Sydney and is shared here with permission. It was written by Professor Michael Nicholas, Clinical Psychologist and Academic Lead for OPEN (Online Pain Education Network). OPEN is an initiative of the University of Sydney, developed in collaboration with Curtin University and national partners to support evidence-informed pain management education for healthcare professionals.
What is OPEN
In 2020, the Australian Federal Department of Health and Ageing awarded researchers and educators at the University of Sydney and Curtin University funding to develop an online training course in pain management skills for all healthcare professionals. This initiative is now known as OPEN (Online Pain Education Network).
OPEN is a social enterprise that translates research into impactful solutions for society as a whole. The training provided by OPEN has been carefully matched against academic research on the healthcare needs and priorities identified by people living with pain across Australia.
“The ultimate goal of OPEN is to facilitate access to the right care for people with disabling pain as locally as possible. In turn, this should lessen the demand for scarce and expensive specialist services,” says Professor Michael Nicholas, Clinical Psychologist and OPEN academic lead, Sydney Medical School (Northern).
OPEN was developed by clinicians, educators and researchers led by the University of Sydney’s Professor Michael Nicholas, Professor Fiona Blyth, Associate Professor Elizabeth Devonshire, Dr Duncan Sanders, Dr Simone De Morgan and Pippy Walker, alongside a team from Curtin University led by Professor Helen Slater, Professor Andrew Briggs, Professor Peter O’Sullivan, Dr Rob Schütze and Dr Roger Goucke (University of Western Australia).
“An innovative approach to this national problem is long overdue,” – Professor Nicholas.
“Despite repeated calls for national action, OPEN represents the first real attempt to provide the same core training in basic pain management skills across all healthcare professionals and students in Australia.
This will make it possible for people seeking help with their chronic pain to be able to access recommended, evidence-based help wherever they live,”
– Professor Michael Nicholas, Pain Management Research Institute.
Chronic pain in Australia
People struggling with disabling chronic pain often report feeling stuck in an endless cycle of investigations and ineffective treatments. The overuse of imaging and opioids is a cogent example of this conundrum. Yet there are ways of helping people with chronic pain to overcome the impact of pain on their lives, and evidence-informed pain management guidelines exist for healthcare professionals to follow.
“Principally, the guidelines boil down to enabling people disabled by chronic pain to develop effective self-management strategies to deal with their persistent pain in partnership with their treating clinicians,” says Professor Nicholas.
“There is a gap between evidence and practice driven by a lack of access to the recommended approaches, combined with ready access to treatments that are not recommended in the guidelines, such as more scans and opioids.”
There is also a lack of confidence among many healthcare professionals in their ability to work alone or collaboratively to provide effective self-management approaches to their patients.
“The reality is that relatively few healthcare professionals have been trained to provide the recommended approaches. Traditional approaches to chronic pain typically focus on pursuing pain relief by reducing pain severity alone,” says Professor Nicholas.
“While this is an understandable goal, many of these traditional interventions are of limited value, and even harmful for some people with chronic pain, and have resulted in a demand for chronic pain care that far exceeds the capacity of current health services to provide.”
This means many people living with chronic pain are referred to specialist pain clinics for more comprehensive help. However, limited capacity and long wait times leave many individuals in limbo and vulnerable to ineffective and short-term ‘quick fix’ solutions.
Reimagining pain care in Australia
Evidence-informed guidelines recommend that, unless there is a treatable underlying condition, people living with chronic pain are best served by avoiding reliance on simple ‘pain relief’ options and instead adopting an active self-management approach with the support of their healthcare professionals.
Professor Fiona Blyth from the School of Public Health at the University of Sydney explains that self-management involves supporting people to take control of their pain management and gradually resume a more active and meaningful lifestyle, even when pain persists.
“This may include overcoming fears or concerns about their pain, gaining an accurate understanding of their pain and confidence in their ability to manage it, minimising reliance on potentially unhelpful medication, and dealing with obstacles such as sleep and mood disturbances, as well as social issues such as social isolation and unhelpful work environments,” says Professor Blyth.
OPEN training to change pain management
The OPEN course comprises 15 modules and is expected to take approximately 20 hours of self-directed learning and practice to complete. Being fully online and asynchronous, the training can be accessed anywhere with an internet connection, at convenient times, and paced to fit around other professional commitments.
“Learning the necessary skills and how to use them requires time and dedication, but these skills will be appreciated by people living with chronic pain,” says Professor Blyth.
Once adopted by more universities and professional groups, OPEN will complement existing pain education and significantly extend pain management skills. Most importantly, healthcare professionals who complete the training will be better equipped to work collaboratively across disciplines to provide person-centred and consistent pain management care.
OPEN will be overseen by representatives from the University of Sydney, Curtin University, the Australian Pain Society, Northern Sydney Local Health District, and two charitable organisations, the Pain Foundation and TDM Foundation. All profits generated by the training will be reinvested into further pain management education and clinical pain research.
OPEN has received financial support from the Department of Health, Disability and Ageing, and philanthropy partners including Hearts and Minds Investments, TDM Foundation and the Pain Foundation. Additional support has been provided by Chronic Pain Australia, Pain Australia, the Pain Foundation and the NSW Agency for Clinical Innovation (ACI).
“We are also excited to share that a partnership approach to dissemination of the training is being promoted by numerous professional bodies, including the Australian Physiotherapy Association, the Australian College of Nursing, the Australian Pain Society, the Australian College of Nurse Practitioners and Pain Nurses Australia, with discussions underway with other bodies,” says Professor Blyth.