by clicking the arrows at the side of the page, or by using the toolbar.
by clicking anywhere on the page.
by dragging the page around when zoomed in.
by clicking anywhere on the page when zoomed in.
web sites or send emails by clicking on hyperlinks.
Email this page to a friend
Search this issue
Index - jump to page or section
Archive - view past issues
Australian Journal of Pharmacy : March 2005
identifying and treating pain Reinventing the wheel on pain Unless community pharmacy can reinvent its role of helping people in pain to find relief, easy access to OTC analgesia from supermarkets may see this important category eroded over time. LISA OFFORD discusses the challenges of developing pharmacy’s expertise in pain management P AIN is one of the most frequent rea- sons for presentation to healthcare professionals; over-the-counter analgesia is a large category in pharmacy and it’s also one of the areas where consumers are most likely to self-medicate. So how does pharmacy make the most of this situation and strengthen its role as a pain advisory service and better help reduce the incidence of unrelieved pain in the community? And what does the phar- macist need to know so the consumer can be made aware of this expertise? While the answers to these questions may be straightforward, there’s no doubt that time, motivation and effort is required before pharmacy can be considered by the public as a pain-management destination. According to experts interviewed by the AJP, the pharmacist and pharmacy teams needs to: • improve its understanding of pain and pain management; • develop systems or methods of delivering advice; and • promote the pharmacy as a pain- advisory destination. Understanding pain According to Geraldine Moses, senior drug information pharmacist at the Mater Hospital in Brisbane, the first things phar- macists need to understand about pain is that there are different kinds of pain, that pain is one of the few physical symptoms that is immeasurable, and that pain is very difficult to judge. ‘Pain is defined by the World Health Organization as an emotional or physical response and it is also governed by your previous experience of pain,’ Ms Moses said. ‘So if you have been in a car crash and have suffered multiple injuries you have a different expectation of what bad pain is going to be like to someone who hasn’t been in such an accident. ‘It is very difficult to judge and conse- quently you have to try to be as non- judgemental as possible,’ Ms Moses said. Taking a pain history from the cus- tomer—identifying the pain, asking how long it has persisted, asking about med- ication and other strategies previously used to relieve the pain and their response 174 ? THE AUSTRALIAN JOURNAL OF PHARMACY VOL.86 MARCH 2005 to it—can help the pharmacist determine best treatment and referral options. Dr Lisa Nissen, lecturer in pharmacy at the University of Queensland, said phar- macists needed to appreciate that med- ications were not always the only answer when it came to managing pain, and that there were other issues that related to pain —particularly persistent or chronic pain. ‘Factors like stress and anxiety, or being off work for a long time, can feed into pain as much as the pain itself,’ Dr Nissen said. ‘The pain experience is really individ- ual and you can’t tar everybody with the same brush.’ Ms Moses said the biopsychosocial model recognised that a lot of pain relief came from the person’s beliefs about pain management. ‘Cultural influences, your past experi- ence, your environment, your support network, are all very much apart of pain management. ‘That’s where pharmacists need to recognise their limitations and not pre- tend to be counsellors, but help people by referring them appropriately to, say, social workers to work through their more psychological issues to do with pain,’ Ms Moses said. She said the pharmacist also needed to have an appreciation of what other con- tributions there might be to the distress associated with the person with pain. ‘For example, some of it might be that they have this romantic belief that if they can just find the one drug, that they can be pain-free—and that’s where pharma- cists often get sucked into doing this trea- sure hunt for yet another drug,’ Ms Moses said. ‘It’s important, therefore, for pharma-