The effect of an interprofessional pain service on nonmalignant pain control

Am J Health Syst Pharm. 2019 May 17;76(Supplement_2):S49-S54. doi: 10.1093/ajhp/zxy084.

Abstract

Purpose: The primary objective of this project was to evaluate an existing interprofessional, nonmalignant pain service by measuring the difference in patient pain scores (numeric rating scale-11) before and after a pharmacist-led pain education class and medication therapy management (MTM) visit. Secondary objectives included determining the percentage of pharmacist recommendations approved, patient satisfaction, and difference in immediate release (IR) and extended release (ER) opioid use before and after enrollment.

Methods: Baseline data were obtained from a retrospective chart review. Enrolled patients attended an educational pain class with the pharmacist. At the MTM visit with the pharmacist 3-14 days after the initial education class, the patient's pain score was assessed along with his/her medication use, and a care plan was developed and forwarded to the referring provider for implementation. Three months after the pain class and participation in the MTM visit, patients were contacted via telephone to complete a survey. The survey questions assessed patient satisfaction with the pain education program, their current pain score, and their knowledge of information covered during the pain class.

Results: Patients reported an average preenrollment pain score of 8.3/10 (n = 39) and a post-survey pain score of 5.6/10 (n = 39). The IR opioid use averaged 19.7 morphine equivalent daily dose (MEDD) at enrollment and decreased by 40% to 11.8 MEDD. The provider approval rate of the pharmacist-recommended interventions ranged from 80% to 92%, depending on the predesignated disease state category.

Conclusion: An interprofessional, nonmalignant-pain service including a pharmacist-led class resulted in a decrease in average pain scores and MEDD in an underserved population.

Keywords: chronic pain; medication therapy management; opioid; pain management; pharmacist.

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects
  • Chronic Pain / diagnosis
  • Chronic Pain / therapy*
  • Community Health Centers / organization & administration
  • Female
  • Humans
  • Male
  • Medication Therapy Management / organization & administration
  • Middle Aged
  • Ohio
  • Opioid-Related Disorders / etiology
  • Opioid-Related Disorders / prevention & control
  • Pain Clinics / organization & administration*
  • Pain Management / methods*
  • Pain Measurement / statistics & numerical data
  • Patient Education as Topic*
  • Patient Medication Knowledge
  • Patient Satisfaction / statistics & numerical data
  • Pharmacists / organization & administration
  • Professional Role
  • Program Evaluation
  • Referral and Consultation / organization & administration
  • Retrospective Studies
  • Surveys and Questionnaires / statistics & numerical data
  • Telephone
  • Vulnerable Populations / statistics & numerical data

Substances

  • Analgesics, Opioid