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Australian Journal of Pharmacy : November 2006
chronic pain management Join the team and gain on pain More than a second opinion Chronic pain offers more treatment challenges than intermittent pain and best outcomes are often achieved via a multidisciplinary healthcare team approach. Conducting a home medicines review can make a difference to the quality of life for many patients suffering chronic pain. KYMBERLY MARTIN explains why ONSULTANT pharmacist and home medicines review (HMR) facil- itator, Dr Jenny Gowan, said the HMR program and pain management momen- tum is gaining as both doctors and phar- macists see how effective the program can be in improving patient outcomes. ‘Previously we had a situation where pharmacists did not recognise the value and importance of HMRs,’ Dr Gowan told the AJP, ‘but now many pharmacists see how working with GPs can be profession- ally rewarding and contribute to deliver- ing an improved use of medicines. Home medicines reviews, she said, give the doctors more information about the patient, what the patient is taking, moni- tor how they are coping and check there is no doubling up of drugs or taking drugs that are out of date. C Some patients suffering from persistent pain can sometimes visit more than one GP if they are unhappy with their med- ications, and this is where HMRs can be helpful, said Professor Peter Carroll, pharmacy academic at the University of New South Wales. ‘During HMRs you find out what the patient is taking. The GP may have pre- scribed medication for pain that the patient believes is not working or has side effects, so the patient will then see another doctor without the knowledge of the first GP or visit other healthcare prac- titioners. This tends to happen when the patient believes they are not getting the best outcomes they expect from a partic- ular provider.’ Fortunately, he said, most people tend to go to one doctor and have their own family pharmacist. Professor Carroll said long-lasting pain can be difficult to treat and one aspect of pain that does present as a major prob- lem is neuropathic pain, caused by nerve damage or dysfunction. This occurs in conditions such as chronic neck or back pain, phantom-limb pain, diabetic neu- ropathy and post-herpetic neuralgia. ‘With these conditions standard anal- gesics are not always effective. So if some- one suffering chronic pain, particularly THE AUSTRALIAN JOURNAL OF PHARMACY VOL.87 NOVEMBER 2006 ? 41