Hello Pharmacy Pain Enthusiasts! I’ve been contemplating various topics for this very first blog post for several weeks and probably mulled over 50 different pain-specific topics. Finally, after a well-rested vacation in Narragansett, Rhode Island, it came to me; I was driving home and speaking with an enthusiastic PGY-1 Pharmacy Resident aspiring to launch an eventual career as a pharmacy pain specialist. Ah, I thought…the perfect topic, especially considering the monthly requests I get from PY-3 pharmacy students curious about what they might expect on a pain rotation in their final year of college. Then there’s the looming carrot that one day, we may [will] see a BPS certification specialty in pain and palliative care. Those specialty attributes were eloquently outlined by a group of pharmacy pain peers in the “Executive Summary, Background and Recommendations: Strategic Planning Summit for the Advancement of Pain and Palliative Care Pharmacy”. The Board of Pharmacy Specialties issued a press release role delineation on April 11, 2011, only to be denied a year later as outlined in an open letter to BPS. How ironic, that just two days following the original announcement on 4/11/2011 that a BPS certification in pain and palliative care would be considered, the FDA released a final Risk Evaluation and Mitigation Strategy (“REMS”) required for all extended-release opioid medications. REMS has since moved forward and on July 9, 2012, the FDA announced the implementation of REMS. All this attention surrounding drug and pharmacist specific pain management is surely a springboard to an imminent successful pharmacy specialty. The question in my mind isn’t “if” it will happen; the question is “when”. So, why should you care, and what should you ask? Here are common questions posed by pharmacy students and PGY-1 residents…
- What do I need to do in order to become a specialist in pain management? Most probably, one would need to complete a PGY-1 residency in general practice, followed by a PGY-2 specialty residency or fellowship in pain (and perhaps) palliative care.
- Are there any groups that I should focus on or join in order to keep my thumb on the pulse of this burgeoning specialty? Yes. ACCP has a pharmacy pain & palliative PRN (network) that focuses on pain and palliative care. ASHP has a Section Advisory Group on Pain Management and Palliative Care; they also have a Pain and Palliative Care Traineeship. Other important groups include the American Pain Society, American Society of Pain Educators, American Academy of Pain Management, and more (feel free to post).
- Are there many PGY-2 pain residencies for pharmacists? There are currently 6 ASHP accredited programs and a few pending accreditation. We started a program at the Stratton VA Medical Center in Albany NY this year and intend to apply for (retroactive) accreditation beginning July 2013. The accredited programs (updated as of August 9, 2013) are as follows:
Name of Site Type Code State Central Arkansas Veterans Healthcare System (PGY2) Palliative Care/Pain Management Pharmacy 71004 AR North Florida/South Georgia Veterans Health System (PGY2) Palliative Care/Pain Management Pharmacy 33012 FL Stratton Veterans Affairs Medical Center (PGY2) Palliative Care/Pain Management Pharmacy 22048 NY Summa Health System – Akron City Hospital (PGY2) Palliative Care/Pain Management Pharmacy 44031 OH The Johns Hopkins Hospital (PGY2) Palliative Care/Pain Management Pharmacy 35110 MD The Ohio State University College of Pharmacy/HospiScript Services, LLC (PGY2) Palliative Care/Pain Management Pharmacy 44047 OH University of California, Davis Medical Center (PGY2) Palliative Care/Pain Management Pharmacy 92066 CA University of Maryland (PGY2) Palliative Care/Pain Management Pharmacy 35318 MD UW Medicine (PGY2) Palliative Care/Pain Management Pharmacy 95007 WA West Palm Beach VA Medical Center (PGY2) Palliative Care/Pain Management Pharmacy 33551 FL
- What kinds of clinical activities do you provide?
- Pain Team member
- Outpatient clinic, therapeutic & pharmacokinetic drug monitoring (serum analysis and urine drug screens)
- Patient evaluations and follow-ups (prescribing medications and ordering necessary lab tests)
- Consultations to primary care providers
- Inpatient consults (acute pain management)
- PCA and interventional devices
- Policy development
- Regular education to all professional staff (pharmacists, MDs, NPs, PAs, RNs, and patients) live and via videoconference/webinar
- ..and lots more
5. What’s the big picture and how might it affect me? Pain management is a huge potential area for growth that is begging for more trained specialists and residency programs in which to train pharmacy colleagues. Another exciting area that has expanded for specialty PharmD’s includes expert legal work, a proficiency that has expanded because so many patients have been harmed by underdosing or overdosing, and an equal amount of prescribers have been falsely accused by patients or regulatory agencies of overprescribing or inappropriately prescribing various analgesics or combinations. Julius Caesar stated the problem well in one short sentence, “It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.” Simply put, our profession needs you! Pharmacists, healthcare providers, students, residents; PLEASE FEEL FREE TO POST! Guest Authors are welcome! Please e-mail Dr. Fudin directly, firstname.lastname@example.org. Click here to read “About Dr. Fudin”.