Non-Pharmacological Therapies (NPTs) are key components in the wellbeing, health and comprehensive care of individuals suffering from a broad spectrum of chronic health conditions. NPTs is a broad term which covers a spectrum of typically non-invasive practices, from physiotherapy and occupational therapy to counseling and other psychological support services. However, few funding options are available to assist Ontarians with limited income sources or healthcare benefits access these therapies. This is particularly troubling in the context of the broad funding that exists for medications on the Ontario drug benefit formulary, through the province’s disability support program. We note that although some dental and vision care is included, many of the beneficial NPTs, like those listed above, are not.
When discussing the ‘Ontario’s Action Plan: Protecting People’s Health and Our Economy’, the 2021 provincial budget, Ontario Finance Minister Peter Bethlenfalvy stated: ‘you can’t have a healthy economy without healthy people’. We agree; that is why there needs to be more access to NPTs through publicly funded programs with the aim of achieving equitable care for Ontarians. Equity in access to care is crucial to achieving positive change for the health of the whole of our population.
As Nurse Practitioners (NPs) working in a Chronic Pain Clinic and caring for patients from differing socioeconomic backgrounds, we have seen first-hand the improved clinical outcomes for individuals who are able to access NPTs. We have a unique perspective as our clinic is funded to provide holistic care for individuals suffering with chronic pain. Through the clinic, these individuals have access to interdisciplinary team members from fields such as physiotherapy, social work, occupational therapy, psychology, medicine, nursing, dietetics, and pharmacy. Despite the access our clients have to these services when they are referred and registered in our clinic, as NPs we see many who struggle to afford necessities. This can include access to appropriate housing, nutritious food, sport and fitness facilities, computers, and internet. In clinical settings where the funding for interdisciplinary care is limited or non-existent, the disparity is devastating. Fulsome participation in the broadest extent of interdisciplinary treatment is limited to those who can afford it
Health Quality Ontario (HQO) has created quality standards and recommendations supporting the use of NPTs that are publicly funded. The organization’s chronic pain quality standard (2020) includes the importance of access to different, non-drug avenues for treatment. These include psychosocial supports, physically-based interventions, and exercise. The best available evidence supports the importance of publicly funded programming, which includes access to NPTs for Ontarians experiencing chronic pain.
We assert that access to all necessary care and treatment needs to be at the forefront of our decision making. Comprehensive funding for NPTs is also one of the best ways to enhance positive change toward equitable healthcare in Ontario. That is why it is critical that the provincial government provide more funding support for NPTs and we would like to see this planning included in future budgets. All Ontarians deserve access to the best care and most appropriate treatment options, regardless of income.
Katie Root-Clarke is a Primary Health Care Nurse Practitioner who graduated from the MN(PHCNP) program at Queens University in 2016. She is currently practicing in the Chronic Pain Clinic as a nurse practitioner with the Kingston Health Sciences Center.
Susanne Jeffery is a Nurse Practitioner currently practicing in the interdisciplinary chronic pain clinic located at the Hotel Dieu site of Kingston Health Sciences Centre.
Dr. Monakshi Sawhney, NP(Adult), PhD, is Associate Professor at Queen’s School of Nursing. In addition to her teaching and research, she currently practices at Hotel Dieu Hospital in the interdisciplinary chronic pain clinic, Kingston Health Sciences Centre. You can find her on twitter @Mona_Sawhney
Jeanette Suurdt is a lecturer at Queen’s School of Nursing. Her clinical nursing background is primarily in Intensive Care and Cardio Thoracic Surgery and she currently works as a Nurse Practitioner at KHSC, Hotel Dieu Hospital site.
Dr. Rosemary Wilson is Associate Director of Graduate Programs at Queen’s School of Nursing. She currently practices at Hotel Dieu Hospital in the interdisciplinary chronic pain clinic and is a nurse practitioner with the Kingston Health Sciences Centre. You can find her on twitter @Kibitkette
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