Pharmacist Delivered Chronic Pain Management
Project Description: Opioid abuse is a common addiction with a high mortality rate. According to the CDC over ninety one Americans die every day from an opioid overdose. Unique to this addiction is its intimate association with medical prescribing - opioids still are and will likely always be an important component to pain management. Physicians and pharmacists are uniquely positioned to address the problem where it starts – in the physician’s office. Today a battery of validated tools exist to aid the physician in preventing and detecting opioid abuse. National pain organizations and the CDC recommend physicians use these tools yet they uncommonly do as the tools are tedious and time consuming to administer, especially since the patient is often being seen for a condition other than pain. We performed an IDR search to evaluate opioid prescribing in the UF Medical Oncology Clinic. From 9/2/2016 – 8/31/2017, 4,445 unique patients were prescribed an opioid and 879 were prescribed a long-acting opioid. Only 241 patients were prescribed a long-acting opioid along with gabapentin, pregabalin, or duloxetine, despite society recommendations to do so. We recruited a clinical pharmacist certified in chronic pain management to co-manage these non-malignant, chronic pain patients. Upon referral from an Oncology Faculty, the pharmacist meets with the patient and routinely checks the state controlled substance registry, administers a functional status questionnaire, an addiction scale, and a urine drug screen. She also administers a pain contract, makes recommendations for alternative analgesics, and follows the patient prospectively.
QPI: Robert, Leverence, (firstname.lastname@example.org)
Collaborators: Long, Dang, (email@example.com); Robert, Leverence, (firstname.lastname@example.org); Irene, Estores, (email@example.com); John, Gums, (firstname.lastname@example.org)
UF Health Big Aims: Zero Harm None
MeSH Keywords: Analgesics, Opioid, Opioid-Related Disorders, Pain Clinics, Pain Management