PROMPT MISSION STATEMENT
Countless published commentaries, blogs, and debates have covered the PROP (Physicians for Responsible Opioid Prescribing) petition submitted to the FDA in July 2012 this year. Coverage of this topic is ubiquitous throughout this website and has become a familiar and popular discussion topic among our readers. As well, the PROMPT (Professionals for Rational Opioid Monitoring and Pharmacotherapy) acronym is equally emblazoned throughout the Internet for their role in opposing the July petition and advocating for patients requiring opioids for chronic non-cancer pain. PROP is comprised of physicians alone, while PROMPT maintains an interdisciplinary group of healthcare providers, many of whom also include physicians.
An unfortunate fallout of various published debates has variously become heated and often misdirected. The whole subject of medically necessary opioid therapy has been grossly overshadowed by this ordeal, as both PROP and PROMPT recognize that opioid therapy is clearly not the only option for chronic pain patients. In fact both groups agree it is often the medication therapy of last resort. Unlike most therapies, opioids carry with them both therapeutic considerations (benefits and risks), psychsocial and highly political issues. As with all politics, there is a very liberal LEFT and very CONSERVATIVE right. Chronic pain patients come in both flavors; politically liberal and conservative. But this is not about RIGHT or LEFT; it’s about RIGHT or WRONG. A significant problem in politics, religion, science, or medicine often surfaces when we have zealots in one camp or another.
Exposition of PROP-PROMPT blogs, attached comments, and other published debate, should serve to remind us all that healthcare providers, at least initially, entered their respective fields with honorable intentions of healing. I still believe this to be true, regardless of which camp our readers and healthcare providers fall. To debunk any doubts that have arisen in the crossfire, one could easily upload copies of the physician’s Hippocratic Oath, The Oath of a Pharmacist, The Florence Nightingale Oath, and others.
As PROMPT members began to draft a Mission Statement, it became abundantly evident that this debate can’t only be about opioids; it’s also about risk stratification, mitigating risks, rational polypharmacy (not just opioids), interdisciplinary expertise, common sense, patient advocates, families, loved ones, behavioral health, psychotherapy, interventional medicine, rehabilitative medicine, alternative medicine, non-traditional medicine, and more.
During this whole process, it is no secret that contaminated intraspinal injections caused Multistate Fungal Meningitis and resultant harm and deaths to numerous patients throughout the United States. That is an unfortunate and unanticipated outcome that should make any of us stop and think about what we do, how we do it, why we do it, the potential benefits versus risks, and long-term impact for our end user, the patient, and their loved ones.
It is with a heavy heart from the ongoing battle of PROP vs. PROMPT and much deliberation and dedication from PROMPT members that we finally developed a Mission Statement. I believe it will be clear to our readers that the final product does in fact reflect concern for patients and fairness to those that care for them, regardless of the preferred medical camp. But, it also demands that scientific validity and risk mitigation are essential components.
It is not just about opioids; it is not just about right or wrong;
IT IS ABOUT SCIENCE; IT IS ABOUT MEDICINE;
IT IS ABOUT THE PATIENT!
To view PROMPT’s Mission Statement, click the link or continue reading below. As always, comments are welcome and will be considered in future revisions of the PROMPT Mission Statement.
PROMPT MISSION STATEMENT
Who is PROMPT?
A diverse group of healthcare professional experts in pain management and patient care advocates.
To advance a universal inter-disciplinary, multi-modal approach in striving for effective pain management, including but not limited to, medically necessary opioids for chronic noncancer and palliative pain management and to advocate for appropriate Federal and State legislative strategies that improve outcomes and mitigate risks throughout the United States for all chronic pain sufferers.
1. Promote valid, reasonable, scientific strategies to guide legislation and balanced policy that do not generate barriers for less traditional but validated therapies, interventions, and/or techniques, and medically necessary prescription opioid use otherwise intended to effectively treat and control chronic pain.
2. Advocate for reasoned opposition to quash all non-evidence based proposals that threaten medically necessary opioid or other prescription medication access by requesting FDA or regulatory label changes or any other therapies that specifically lack scientific validity that potentially impose unintended consequences to chronic pain sufferers.
3. Support healthcare provider, public, legislative, and policymaker education.
4. Encourage and support lobbying efforts at the Federal and State levels regarding the consequences of non-evidence based proposals, petitions and/or other similar proposals.
5. Support ongoing dialogue and discussion with proponents of petitions to change the paradigm for which pain medications, including medically necessary opioids are prescribed, healthcare professional organizations, and other stakeholders to reach a consensus about appropriate medication use strategies and risk mitigation.
6. Provide empathetic support and a channel of voice for those who have bereaved for family and loved ones, where acceptable medical therapeutics were employed, but due to adverse outcomes from interventional, medication, and/or modality-based treatments, unfortunate consequences occurred.
7. Encourage implementation of tested, proven, evidence-based strategies, such as public health demonstration models for prescription opioid use that reduces mortality and mitigates untoward risks of opioids in Society – one such successful model is Project Lazarus of Wilkes County, NC that did not include FDA or regulatory label changes to opioids.
8. Promote valid, scientific research into the safety and effectiveness of all prescribed treatments including but not limited to medically necessary opioid drugs.
9. Support education of medically necessary opioid pharmacotherapy in chronic pain management into the curricula of all healthcare colleges, training programs, and organizations involved with delivering continuing professional education.
10. Encourage education to the healthcare community regarding the role of law enforcement and opioid, misuse, and abuse in Society.
11. Promote a workable and collaborative approach with law enforcement agencies and/or officials to abolish “pill mills” at local, regional, state, and national levels.