title: Answering the call to address chronic pain in military service members and veterans: Progress in improving pain care and restoring health.
abstract: Chronic noncancer pain (CNCP) in military and veteran populations mirrors the experience of chronic pain in America; however, these two populations have unique characteristics and comorbid conditions such as traumatic brain injuries, postconcussive syndrome, posttraumatic stress disorder, and behavioral health disorders that complicate the diagnosis and treatment of chronic pain. Military members and veterans may also be stigmatized about their conditions and experience problems with integration back into healthy lifestyles and society as a whole following deployments and after military service. The military and veteran health care systems have made chronic pain a priority and have made substantial strides in addressing this condition through advances in practice, education, research, and health policy. Despite this progress, significant challenges remain in responding to the wide-spread problem of chronic pain. The purpose of this article is to: (a) examine the state of CNCP in military and veteran populations; (b) discuss progress made in pain practice, education, research, and health policy; and (c) examine research, evidence-based practice guidelines, and expert consensus reports that are foundational to advancing pain care and improving health for military service members and veterans with CNCP. In addition, recommendations are proposed to address this widespread health problem through the expanded use of advanced practice registered nurses, the implementation of models of care, and use of national resources to educate health care providers, support practice, and promote effective pain care.
authors.affiliation: Education and Professional Development, American Association of Nurse Anesthetists, Park Ridge, IL. Electronic address: bschoneboom@aana.com.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Schoneboom
authors.affiliation: Graduate Acute Care Programs, CRNA Program, University of South Florida College of Nursing, Tampa, FL.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Perry
authors.affiliation: University of Iowa School of Nursing, Iowa City, IA.
authors.forename: William Keith
authors.initials: WK
authors.lastname: Barnhill
authors.affiliation: Hillman Scholar in Nursing Innovation, University of Pennsylvania School of Nursing, Philadelphia, PA.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Giordano
authors.affiliation: Nurse Anesthesia Program, University of Pennsylvania School of Nursing, Philadelphia, PA.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Wiltse Nicely
authors.affiliation: University of Pennsylvania School of Nursing, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
authors.forename: Rosemary C
authors.initials: RC
authors.lastname: Polomano
mesh_terms: D000328:Adult; D057179:Advanced Practice Nursing / Q000379:methods*; D000700:Analgesics / Q000627:therapeutic use*; D001930:Brain Injuries / Q000188:drug therapy / Q000451:nursing*; D059350:Chronic Pain / Q000188:drug therapy / Q000451:nursing*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D059408:Pain Management / Q000379:methods* / Q000451:nursing*; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000451:nursing*; D014728:Veterans; D055815:Young Adult
chemical_list: D000700:Analgesics
keywords: Advanced practice registered nurses; Chronic pain; Military; Pain management; Veterans