Community pharmacists and chronic pain: Developing and implementing a pain medication management program

Abstract

Objective: The goals of this study are to design and implement a pain medication management program at a community pharmacy and determine the impact on pain control, medication side effects, and appropriateness of therapy based on type of pain. Methods: Chronic pain affects as many as 100 million people in the United States and poor pain control is widespread. Pharmacist-led medication reviews in primary care settings are shown to improve pain control and facilitate safe and appropriate prescribing; however, there is limited research about community pharmacist involvement in chronic pain management. This prospective study will be implemented at one location of a large grocery chain pharmacy. Inclusion criteria are: (1) patients taking one or more short-acting opioids or opioid-like medications, at least one of which is used more than three times daily or (2) patients taking two or more long-acting opioids or opioid- like medications. Patients who agree to study participation will go through a comprehensive medication review with a pharmacist and baseline data will be obtained, including pain control, side effect profile, and type of pain. Patients who decline participation will be asked to provide baseline data and will serve as the control group. Patients in the treatment group will receive counseling, with a focus on managing side effects and nonpharmacological approaches to pain management. If it is determined that the patient might benefit from a different medication regimen, this will be discussed with the patient and suggested medication changes will be communicated to the prescriber. Follow-up will be completed after 45 days. Outcomes will be measured at baseline and followup, using the Pain Impact Questionnaire (PIQ-6) to assess pain control and the Numerical Opioid Side Effect tool to assess side effects; medication changes also will be assessed at follow-up.