Ideas and innovations: Inclusion of pharmacists in chronic pain management services in a primary care practice

2017 ◽  
Vol 7 (6) ◽  
pp. 484-487
Author(s):  
Robin Moorman Li, PharmD ◽  
Rachel Hrabchak Franks, PharmD ◽  
Steven G. Dimmitt, DO ◽  
George R. Wilson, MD
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Care Physician ◽  
Care Practice ◽  
Chronic Pain Management ◽  
Proper Patient Selection ◽  
Pain Specialist

Nonmalignant chronic pain management involves an ongoing process of complex evaluations including proper patient selection, proper prescribing, and careful monitoring. In the Pain Management Refill Clinic, patients are stabilized on an opioid regimen by either a pain specialist or a primary care physician (PCP). The PCP assumes long-term prescription of the regimen and proper follow-up. The inclusion of pharmacists in the management of patients suffering from chronic pain has allowed the physicians to improve opioid prescribing, documentation, and monitoring in accordance with chronic nonmalignant pain guidelines.

scholarly journals Evaluation of Primary Care Physician Chronic Pain Management Practice Patterns

2018 ◽  
Vol 1 (21;1) ◽  
pp. E593-E602 ◽  
Author(s):  
David Provenzano
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Primary Care Physician ◽  
Response Rate ◽  
Care Physician ◽  
Assessment Tools ◽  
Chronic Pain Management ◽  
Convenience Sample ◽  
Knowledge And Practice

Background: The management of chronic pain is complex and often involves the integration of multiple clinical, humanistic, and economic factors. Primary care physicians (PCPs) are often at the forefront of managing chronic pain and often initiate pharmacological pain management therapy. To date little is known surrounding the pain management practices of PCPs. Objective: The purpose of this study is to assess the knowledge and practice of PCPs in management of chronic pain. Study Design: A survey. Setting: Western region of Pennsylvania, US. Methods: A cross-sectional questionnaire survey evaluated PCPs pain management treatment practices including assessment of chronic pain, procedural activities surrounding therapy, decision-making input, and knowledge for therapeutic pain management including the 5 main classes of medications. The questionnaire was developed based on a review of the literature including published chronic pain guidelines. The questionnaire was mailed to a convenience sample of 300 PCPs practicing in Western Pennsylvania. The study was approved by the University Institutional Review Board. Results: The survey had a response rate of 16%. The respondents on average treated 30 chronic pain patients per month predominately in a community setting. The most common conditions treated included osteoarthritis, back and neuropathic pain. Although the major reported source of education was published literature, only 67% respondents referred to pain management guidelines. Multiple knowledge and practice gaps were identified surrounding pharmacological treatment, medication management including compliance practices, and pain assessment. Limitations: Although low, the response rate is comparable to response rates for other chronic pain management topics including anticoagulation and prescription patterns for chronic pain physicians. Also, greater than 50% of the respondents were from private practice, therefore, the results may not pertain to other practice settings including academic and hospital-based practices. Conclusions: The survey provided significant insight into PCP practices and highlights areas for future educational efforts. Further opioid prescribing education would be beneficial especially regarding the utilization of opioid risk assessment tools, the selection of opioids, and opioid end organ effects. Furthermore, patient education on the realities of chronic pain management and the importance of nonpharmacological treatment are needed in order to reduce the challenges faced by PCPs surrounding chronic pain management. Key words: Chronic pain, primary care physician, pain management, survey questionnaire

Identifying Teaming in Chronic Pain Management Interventions in Primary Care: A Systematic Review

2021 ◽  
Vol 2021 (1) ◽  
pp. 11391
Author(s):  
Karleen F. Giannitrapani ◽  
Natalie Connell ◽  
Pallavi Prathivadi ◽  
Sophia Zupanc ◽  
Hong-Nei Wong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Chronic Pain Management ◽  
Management Interventions

Tools, Time, Training, and Team—Military Primary Care Providers’ Perspectives on Improving Chronic Pain Assessment and Management

2021 ◽  
Author(s):  
Asha Mathew ◽  
Honor McQuinn ◽  
Diane M Flynn ◽  
Jeffrey C Ransom ◽  
Ardith Z Doorenbos
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Pain Assessment ◽  
Insurance Coverage ◽  
Primary Care Providers ◽  
Stepped Care ◽  
Chronic Pain Management ◽  
Care Providers ◽  
Pain Care

ABSTRACT Introduction Primary care providers are on the front lines of chronic pain management, with many reporting frustration, low confidence, and dissatisfaction in handling the complex issues associated with chronic pain care. Given the importance of their role and reported inadequacies and dissatisfaction in managing this challenging population, it is important to understand the perspectives of primary care providers when considering approaches to chronic pain management. This qualitative descriptive study aimed to comprehensively summarize the provider challenges and suggestions to improve chronic pain care in military primary care settings. Materials and Methods Semi-structured interviews with 12 military primary care providers were conducted in a single U.S. Army medical center. All interviews were audio-recorded and lasted between 30 and 60 minutes. Interview transcripts were analyzed using ATLAS 9.0 software. Narratives were analyzed using a general inductive approach to content analysis. The Framework Method was used to organize the codes and emergent categories. All study procedures were approved by the Institutional Review Board of the University of Washington. Results Four categories captured providers’ challenges and suggestions for improving chronic pain care: (1) tools for comprehensive pain assessment and patient education, (2) time available for each chronic pain appointment, (3) provider training and education, and (4) team-based approach to chronic pain management. Providers suggested use of the Pain Assessment Screening Tool and Outcomes Registry, more time per visit, incorporation of chronic pain care in health sciences curriculum, consistent provider training across the board, insurance coverage for complementary and integrative therapies, patient education, and improved access to interdisciplinary chronic pain care. Conclusions Lack of standardized multifaceted tools, time constraints on chronic pain appointments, inadequate provider education, and limited access to complementary and integrative health therapies are significant provider challenges. Insurance coverage for complementary and integrative health therapies needs to be expanded. The Stepped Care Model of Pain Management is a positive and definite stride toward addressing many of these challenges. Future studies should examine the extent of improvement in guidelines-concordant chronic pain care, patient outcomes, and provider satisfaction following the implementation of the Stepped Care Model of Pain Management in military health settings.

Buprenorphine for Long-Term Chronic Pain Management: Still Looking for the Evidence

2020 ◽  
Vol 172 (4) ◽  
pp. 293
Author(s):  
Michael E. Schatman ◽  
Hannah Shapiro ◽  
David J. DiBenedetto
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Chronic Pain Management

Buprenorphine for Long-Term Chronic Pain Management: Still Looking for the Evidence

2020 ◽  
Vol 172 (4) ◽  
pp. 294
Author(s):  
Roger Chou ◽  
Jane Ballantyne ◽  
Anna Lembke
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Chronic Pain Management
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