Physicians Recognize R.Ph.S' Role in Pain Management

By LoBuono, Charlotte | Drug Topics, March 18, 2002 | Go to article overview

Physicians Recognize R.Ph.S' Role in Pain Management


LoBuono, Charlotte, Drug Topics


Rx CARE

In order to address the issue of undertreatment of pain in the United States, pharmacists are ire ingly being induded in the development of pain-management policies. This was one of the themes discussed at a recent media briefing on pain management sponsored by the American Medical Association and held in New York City.

According to Herman Abromowitz, NLD., member, AMA Board of Trustees, "AMA policy dictates that state medical associations and boards of medicine develop or adopt mutually acceptable guidelines for attending physicians to appropriately prescribe and/or administer controlled substances for the relief of intractable pain. The AMA supports the prevention and treatment of pain through aggressive and scientifically appropriate means.

Last Dembe, the AMA, the Joint Commission on Accreditation of Healthcare Organizations ([CAHO), and the National Committee for Quality Assurance (NCQA) announced an initiative to develop a common set of evidence-based measures for the asses of the efficacy and appropri ateness of palliative care for those suffering from cancer, back pain, and arthritis, Abromowitz continued. This initiative represents a major effort to improve palliative care in this country.

One way to improve palliative care is through preemptive pain. management Postoperative pain is perhaps our most understood pain, said Mark Lema, M.D., PhD., chairman, department of anesthesiology and pain medicine, Roswell Park Cancer Institute, and professor and chair, department of anesthesiology, University at Buffalo, State Universi ty of New York, School of Medicine and Biomedical Sciences, Buffalo. Physicians may be reluctant to use pain-killing drugs, however, because they may be wary of the troublesome side effects associated with the use of painkillers and are concerned about addiction risk.

Patients need not suffer distressing pain when undergoing surgery, Lema continued. Techniques exist to optimize pam relief and speed recovery following a procedure. These methods include premedication with the nonopioid COX-2 inhibitors, the use of regional nerve blocks or simply infiltrating the surgical scar with local anesthetic, and other methods. Maintaining nonsteroidal antiinflammatory drug therapy with COX-2 inhibitors as well as epidural therapies and other blocks during the postsurgical period can markedly reduce the amount of opioid therapy used, allowing the gut to recover faster, he said. …

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