The use of medication for chronic pain in primary care, and the potential for intervention by a practice-based pharmacist

Abstract

We have demonstrated a method of identifying patients with chronic pain in primary care, and the feasibility and acceptability of a pharmacist-led intervention. This is of potential value in primary care, as relevant prescribing recommendations were made for most patients although further research is required to assess these.

Using the costs of drug therapy to screen patients for a community pharmacy-based medication review program

“…Studies reported variable implementation rates of recommendations related to DRPs, ranging from 29% [4] to 84% [26]. To our knowledge, no study has investigated the implementation of recommendations related to EPs only.…”

Effectiveness of Pharmacist-Led Medication Reviews in Improving Patient Outcomes in Chronic Pain: A Systematic Review Protocol

“…However, limited and inconsistent clinical and research evidence is available to support these claims in the context of chronic pain. [11][12][13][14] A systematic review evaluating effectiveness of pharmacist-led educational interventions for chronic pain management reported a statistically significant reduction in pain intensity of 0.5 on a scale of 0 to 10, a reduction in adverse effects by 50% and an improvement in patient satisfaction with the treatment equivalent to 1 point on a 0 to 10 point rating scale in patients receiving interventions as compared to the control group. 15 To date, no systematic review has evaluated the effectiveness of pharmacist-led medication review for chronic pain management.…”

The pharmacist’s role in managing chronic opioid therapy

“…McDermott et al [33] published a study in 2006, one aspect of which was to assess prescribing recommendations that were made after a pharmacist-led review of analgesic prescribing and to identify the proportion of these acted on by general practitioners. A computer database was used to identify patients with chronic pain, and treatment protocols for chronic pain were agreed on at the start of the study [33].…”

“…A computer database was used to identify patients with chronic pain, and treatment protocols for chronic pain were agreed on at the start of the study [33]. The study pharmacist reviewed the safety and efficacy of medication regimens in 132 patients.…”

“…The study pharmacist reviewed the safety and efficacy of medication regimens in 132 patients. The study pharmacist used information from patients' medical records, questionnaires that contained health information including a patient assessment of chronic pain (using the Chronic Pain Grade questionnaire), and patient interviews (done with 23 patients) [33]. The pharmacist made 192 recommendations for 113 patients, 107 of these being related directly to analgesic use [33].…”