We’re Back! A Pain Pharmacist’s Story.

 

Welcome Back!

After a long hiatus, the PainDr team is back!

We appreciate the patience and support while we have taken a step back this year to re-evaluate the PainDr blog and establish approaches to achieve continued success. However, the primary goal of the PainDr site remains to continue in our founder’s (Dr. Jeffrey Fudin’s) legacy of producing educational content for clinicians and patients alike, to expand the knowledge of pain management, and to set the record straight as it relates to this opioid therapeutics.

These blogs will get back to their usual line of patient- and clinician-centered education and collaboration between us all. Just as they did when our founder first started them in 2012. Check out the PainDr website to see a few minor tweaks and changes, and follow our pages across all social networks to stay updated on the latest and greatest from the pain management field (Linkedin, Twitter, Facebook, and Pinterest). The Lemonade Series will remain separate and untouched, as that is sure to withstand the test of time. We also plan on opening up to sponsored blogs as a standalone category as well, for anyone interested.

Now, speaking of when these blogs first started, we figured why not kick off our grand re-start with an update of (and tribute to) the original blog on this site (Pharmacy Pain Specialists Are Needed!). To answer that question posed by Dr. Fudin almost eleven years ago:

 

YES, pharmacy pain specialists are (STILL) needed!

 

What the Heck is a Pharmacy Pain Specialist?

This is still one of the most frequently asked questions our specialty receives from patients, caregivers, and other healthcare clinicians alike. Simply put, pain pharmacy specialists (or pain pharmacists) are pharmacists trained in pain and palliative care (usually). This training is most often completed via two post-graduate year (PGY) residencies, though can also involve pain/palliative care fellowships or clinical experience in pain management from a different subspecialty (just like our Founder did years ago – Oncology to Pain Management, makes sense). Because of this training, pain and palliative care pharmacists help manage many pain conditions (acute, chronic, cancer/palliative related), as well as comorbid conditions often associated with pain itself (depression, anxiety, substance use disorder, etc). We generally work with a team of physicians, integrating with pain management, palliative care, neuropsychiatry, primary care, and hospice, amongst others.

And, just so we are clear, YES, most of us have the authority to prescribe non-controlled and controlled medications to varying degrees (this mainly has to do with state-level prescriber status). Of course, because we cannot diagnose, collaboration with our physician, NP, and PA counterparts is paramount in optimizing outcomes across the pain and palliative care field. And, to be doubly clear, there is an abundance of evidence showing that pain pharmacists improve patient and provider level outcomes across the spectrum of pain management and palliative care.

Remember, colleagues, we pharmacists are NOT looking for a turf war (that includes YOU American Medical Association)! We are looking to further collaborate to not only improve our patients’ quality of life but also to actually reduce some burden at the provider level.

 

As Jerry Maguire said, “Help me, help you!”

 

 

Pain and Palliative Care Residencies

Perhaps one of the greatest developments since our founder’s initial blog post eleven years ago has been the expansion in the amount of pain and palliative care pharmacy residency programs. At that time, there were a measly six accredited second year residency programs, with four pending accreditation. There are now 30 accredited residency programs (some with multiple residency slots), with several programs pending accreditation, and some that are unaccredited. See ASHP directory link.

That’s a THREE-FOLD increase in residency programs over the span of just 10 years!

Talk about pain pharmacist power!

It’s a reflection of the increased realization of the need for pain specialist pharmacists with training to help support patient centered care in one of the most difficult and costly (physically, emotionally, financially) disease states to treat (pain). It also is a testament to the work that pain and palliative care pharmacists of the past and present have done to build up our profession, and the path they continue to lay out for us. We will reserve a proper tribute for another post (shout out to the SPPCP organization in particular).

These residencies are where we train in cross-disciplinary ways, often rotating under various pain related specialties (chronic pain management, acute pain management, palliative care, hospice, Neurology, Rheumatology, Psychiatry, Addiction Medicine, etc, etc) with interdisciplinary preceptors (pharmacists, physicians, PAs, NPs, psychologists, etc). While our focus is often on becoming the go-to experts in pain, psychiatric, palliative, and addiction medicine medications and management of those disease states, the interdisciplinary training enhances our clinical assessment and patient interviewing skills as well. To re-iterate, this is NOT to diagnose!! However, these assessment skills are often vastly important in collaborating with our diagnosing colleagues, often adding to the clinical picture of the patient and allowing a more targeted approach.

 

Say it with me, “HELP ME HELP YOU!”

 

 

The Future of Pain and Palliative Care Pharmacists

So, to pharmacy students curious about what the future of pain and palliative care pharmacists looks like. To the clinicians in search of help in managing an incredibly complex disease state. To the patients with all types of pain who need patient advocates willing to take time and work with them at the patient level around goals in improving quality of life and pain outcomes.

To further elaborate on Dr. Fudin’s opinion on this very topic a decade ago.

Pain pharmacists are here, and here to help you ALL!

There’s no doubt that it is a specialty field worth pursuing if you are a student pharmacist reading along or collaborating with if you are a practitioner considering the addition of a clinical pharmacist to your practice. We know that with increased collaboration, there is enhanced recognition of the importance of pharmacist involvement in this type of care! With an aging population, more stressors on our healthcare system than ever before, and continued advocacy from all pain and palliative care pharmacists, the growth of our specialty really has no ceiling.

 

Oh, and PS… Board Certification for the Pain and Palliative Care Pharmacy specialty may be on its way, as it is open to public comment right now! Just as it was more than a decade ago when this blog first started.

Time really is a flat circle!

 

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