Pain Management in Serious Illness: The Palliative Medicine Approach

Pain is one of the most feared and burdensome aspects of living with a serious illness. Uncontrolled pain can negatively impact the ability to complete activities of daily living, to maintain employment, to tolerate disease-directed therapy, and to maintain emotional and psychological health. Palliative medicine is a subspecialty that aims to relieve suffering in all stages of serious illness. Palliative medicine teams are usually made up of physicians, advanced practice providers, nurses, chaplains, clinical social workers, and pharmacists. The holistic and interdisciplinary approach employed by palliative medicine teams can be applied in a wide range of disease processes, including cancer, COPD, heart failure, cirrhosis, AIDS, etc. This chapter presents an overview of the strategies employed by palliative medicine teams to treat pain in the context of serious illness.