UK Undergraduate Doctors May be Unprepared to Manage Pain - One of the Most Common Problems They Will Encounter in Clinical Practice, Expert Group Warns
CAMBRIDGE, England, October 10, 2013 /PRNewswire/ --
First ever Europe-wide study reveals a lack of compulsory modules for pain within UK medical schools
There is an alarming lack of dedicated teaching on pain in undergraduate medical schools in Europe, according to the APPEAL (Advancing the Provision of Pain Education And Learning) study,[1] the first Europe-wide study on pain education provision. Of those undergraduate medical schools examined in the UK, only 11% offered a dedicated pain module, with 32% having no documented evidence of pain teaching on their curriculum, and only 4% requiring that all medical students undertake some form of pain training.[1] The APPEAL study was presented at the annual congress of the European Pain Federation EFIC® in Florence.
The study highlighted that the greatest evidence of the omission of compulsory pain teaching is seen in the UK, Ireland, Belgium, Switzerland and Bulgaria, versus evidence of 100% of schools having compulsory pain teaching in Denmark, Poland, Romania and Sweden.[1]
Uncontrolled pain has a significant negative socioeconomic impact, with back pain alone estimated to result in nearly 5 million sick days a year, accounting for 1 in 6 days taken off annually,[2] and costs of over £12.3 billion a year for the UK economy.[3]
The findings of the APPEAL study suggest that the inadequacies in pain teaching leave future doctors unprepared to treat and manage pain.
"A lack of knowledge about pain among physicians has long been recognised as a key barrier to effective pain treatment and management," said Professor Hans G. Kress, President of EFIC®. "This study shows us that, at best, we are educating our young physicians for only 0.2 per cent of their studies on how to deal with one of the most frequent problems they will encounter in medical practice."
Pain teaching not a priority
The APPEAL study, funded by Mundipharma International Limited and guided by a multi-disciplinary Taskforce of experts under the leadership of EFIC®, highlights that pain teaching is not a priority in undergraduate medical curricula. The study involved the review of publicly available curricula from 28 medical schools in the UK and found that there was a lack of consistency in the way pain education was delivered.
"Although it is shocking to see how poorly the UK compared to other European countries such as France and Germany, unfortunately, the results of the APPEAL study reinforce findings previously published by the British Pain Society," explained Dr Emma Briggs, Lecturer, King's College London, and Chair, British Pain Society Pain Education Special Interest Group. "It is essential that the provision of undergraduate pain education across the UK is fit for purpose to address the current and growing unmet public health need. We need to embrace models of best teaching and learning practice within all our universities to ensure healthcare professionals can effectively manage pain."
Pain teaching inconsistent in the UK
The APPEAL study found that more than half of all undergraduate medical schools in the UK offer pain teaching only within other subjects - and that these subjects vary across schools.[1] Teaching methods also vary across schools. Although the majority of schools (77 per cent) use classroom-based teaching, other teaching methods vary - only 45 per cent of schools use practical-based teaching and even fewer (32 per cent) use case-based teaching.[1]
Based on the findings of the study, the APPEAL expert Taskforce calls on medical schools, pain specialists, medical students and relevant policymakers to ensure that pain education for undergraduate medical students across Europe is fit for purpose to address the current unmet public health need to adequately manage and treat pain. More specifically, the expert Taskforce recommends:
- The establishment of a European framework for pain education, developed jointly by pain specialists and educators and drawing on the EFIC® Core Curriculum in Pain Management, to ensure consistency in pain teaching within the undergraduate medical curriculum and between medical schools in Europe
- The introduction of compulsory pain teaching for all undergraduate medical students in Europe, to enable them to acquire a defined minimum level of competency in pain and up-to-date pain management
- Improved documentation of pain teaching within the undergraduate medical curriculum, with clearly stated teaching content and defined student competencies in pain.
Notes to editors
About chronic pain
Chronic pain affects 1 in 5 adults in Europe yet it remains poorly managed and under treated.[4] Lack of knowledge about pain among physicians is recognised as one of the key barriers to effective pain treatment and management.[5] The previous evidence base indicates that pain education in many of the current undergraduate courses is inadequate preparation for professional practice, with inconsistencies in the way that it is taught.[6],[7],[8],[9] There is an urgent need to understand the gaps in the provision of pain education in order to address the deficit in healthcare professional knowledge of pain.[5]
About the APPEAL study
The APPEAL study is the first ever review of undergraduate pain education across Europe. Conducted in 15 European countries, it involved the review of publicly available curricula from 242 undergraduate medical schools and goes beyond existing research, providing a more comprehensive analysis and understanding of pain learning. The study was guided by an expert Taskforce of pain and education specialists under the leadership of the European Pain Federation EFIC®. The research was conducted from April to September 2013 by independent research company Adelphi Research. The APPEAL study was conducted as part of a Europe-wide initiative aiming to raise the profile and importance of pain education. Mundipharma International Limited provided financial, logistical and editorial support.
About Napp Pharmaceuticals Limited
Napp Pharmaceuticals Limited is part of the Napp Pharmaceutical Group, a privately owned group of UK companies that are part of a worldwide network of independently associated companies that have been providing innovative medicines since the 1920s. Napp has been based on the Cambridge Science Park since the early 1980s and is currently the 12th largest pharmaceutical company in the UK based on community prescription sales (IMS data).
Napp has a strong track record in providing innovative treatments that make a positive difference to patients' lives. Napp is a leader in the field of pain control, and has been committed to furthering the understanding and treatment of pain for over 30 years. They are committed to becoming a long-term partner in respiratory medicine and they have a growing oncology portfolio, which is currently focused on improving treatment options for patients with blood cancers.
About KCL
King's College London is one of the top 20 universities in the world (2013/14 QS World University Rankings), and the fourth oldest in England. A research-led university based in the heart of London, King's has more than 25,000 students (of whom more than 10,000 are graduate students) from nearly 140 countries, and some 6,500 employees. King's is in the second phase of a £1 billion redevelopment programme which is transforming its estate.
King's has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £450 million.
King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar.
King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: http://www.kingshealthpartners.org.
References
1. A Blueprint for Pain Education - the APPEAL (Advancing the Provision of Pain Education and Learning) study 2013, Mundipharma data on file
2. Patient Association - public attitudes to pain report - http://www.patients-association.com/Portals/0/Public/Files/Research%20Publications/PUBLIC%20ATTITUDES%20TO%20PAIN.pdf
3. Department of Helath. Chief Medical Officer 2008 Annual Report.
4. Breivik H, et al. Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. Eur J Pain 2006;10:287-333
5. Montreal Declaration, 2010 International Pain Summit (IPS) of the International Association for the Study of Pain (IASP). Available from: http://www.iasp-pain.org/Content/NavigationMenu/Advocacy/DeclarationofMontr233al/default.htm. Accessed: September 2013
6. Briggs E, et al. Survey of undergraduate pain curricular for healthcare professionals in the United Kingdom. E J Pain 2011;15:789-795
7. Tauben DJ and Loeser JD. Pain education at the University of Washington School of Medicine. Journal of Pain 2013;431-437
8. Watt-Watson J, et al. A survey of prelicensure pain curricula in health science faculties in Canadian universities. Pain Res Manage 2009;14:439-44
9. Mezei L. et al. Pain education in north American medical schools. J Pain 2011; 12:1199-1208
UK/CORP-13360 Date of Preparation: September 2013
Contact
Louise Nathanson or Jim Baxter - napp@hanovercomms.com +44(0)207-092-3388
Oliver Stannard, Communications Officer, The Florence Nightingale School of Nursing and Midwifery
King's College London - nightingalecomms@kcl.ac.uk +44(0)20-7848-3062
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