Pain School and Opioid Renewal Clinic

Pain School and Opioid Renewal clinic Sondra Adkinson, PharmD DAAPM,CPE

Disclosure

Nothing to Disclose

Learning Objectives Describe at least four steps to developing a Pain School List five disciplines who may be part of a Pain School faculty Review selected key topics to provide in a Pain School

Steps To Start A Pain School  RESOURCES  Who - What - Where – When - How – Faculty – Space – Content – Resources – Process – Outcomes

Who Customer – Consult Patient Family member(s) Facilitator – shared FTEE Clerk IT Support

Who (cont’d) FACILITATORS  Pharmacist  ARNP  Recreational Therapist  Physical Therapist  Psychologist  Music Therapist  Social Worker

What Group Education –Develop a Mission Statement: To initiate the transition from pain patient to person by learning about pain and becoming active in their own pain management

What (cont’d)  Orientation & Understanding Pain  Re-engaging with life – Recreation  Body Mechanics – Physical  Medication and Other Strategies  Mindfulness, Coping and Behavioral  Music Therapy  Sleep Hygiene

Where  Room  Accessible  Accommodate size of group  Furniture  Electronic  Facilities  Consistent

When Weekly: Tuesdays Time: 10:30-noon (90min) Three or more scheduled/consults DIGMA DVD Video Teleconference multiple sites

How Content structured and appropriate Resources visual, printed and current Reproducible Flexibility Review regularly Outcomes – Satisfaction, Oswestry

EVIDENCE Primary Care & Health Section –Original Research Article –Preclinic Group Education Sessions –Reduce Waiting Times and Costs at Public Pain Medicine Units

Davies et al. PAIN MEDICINE 2011; 12:59-71 Wiley Periodicals, Inc.

“Steps”  Self-Training Educative Pain Sessions = “Pain School” = “Group Education”  Reduced waiting times  Reduced costs at public Pain medicine units  Increased the use of active pain management strategies  Increased Patient Satisfaction

More Evidence  March 2012: FEDERAL PRACTITIONER – Cosio, Hugo, Roberts and Schaefer – Jesse Brown VA Medical Center, Chicago, Illinois – “A Pain Education School for Veterans: Putting Prevention Into VA Practice”

 Serve: Patient's with chronic pain, who may also be unemployed, disabled, diagnosed with a mental illness and or who also have substance abuse with a face to face group pain education program

Pain Education School 6 Steps  Initiate and maintain a prevention team  Assess preventive services  Develop and implement a prevention program  Get buy in from staff and management  Measure outcomes  Share information and best practices

Sample Classes  Osteopathic manipulation  Surgical procedures  Pharmacotherapy  Smoking Cessation  Nutrition and MOVE  Physical Rehab & OT  Recreational  CBT and ACT groups

 Mental Health  Vocational Rehab  Hypnosis & Biofeedback  Chaplain Services  Sleep hygiene  Acupuncture  Suicide Prevention  Sexual Health

BPVA – Opioid Renewal Clinic PharmCare Pain Management –Consulted by Primary Care –Chronic Stable non cancer pain –Rx controlled substance C-II –Opioid agreement –UDS –Adjuvants –Regular monitoring: Clinic, Phone, UPS

Other Innovations In Primary Care  E-Pain Consulting: Dr. Sproul  Primary Based Pain Teams: Dr. McKelvey  Opioid Renewal Clinics: Dr. Wiedemer  PANEL DISCUSSION: All