Residency
Pain Management Center Rotation
Preceptor:
Arthur Lipman, PharmD, FASHP
Description of Practice Site:
Chronic pain is one of the most inconsistently treated medical problems in our society. The Pain Management Center employs a highly successful interdisciplinary approach to this problem which costs American society over $60 billion a year. Because drugs are such important modalities and often create problems in the care of chronic pain patients, pharmacotherapy is an integral and essential component of pain management.
The majority of time is spent working with chronic pain patients. A brief rotation on the acute pain service is included in the clerkship and residents interested in palliative care may also spend time on that service.
Pharmacy residents will play an active role in providing pharmaceutical care at the Pain Management Center and the University Headache clinic. Residents will work with pain management-boarded physicians from a variety of disciplines, physical therapists, psychologists, and advanced practice nurses to provide patients with optimal pain management.
Average Number of Patients:
The Center sees approximately 30 per day including four to six new patients five days a week. A regular Pharmacotherapy Clinic schedule is posted daily and includes three to six new or followup patients. In addition, physicians and other team members often ask the pharmacotherapy staff (including the residents) to see additional new or followup patients for whom pharmacotherapy consultation is needed.
Patient Care Responsibilities in this Area:
Pharmaceutical care of pain patients consists of obtaining comprehensive medication histories and developing pharmaceutical care plans. A collaborative practice agreement is in place. These histories are obtained when patients are initially evaluated or when patients are seen in a follow-up visit. A pharmacist bases the pharmaceutical care plans on objective and subjective data and assessment of the patients. Plans include changes in patients' medication regimens, which are implemented through collaboration by the pharmacist with the patient's physician. These typically include: eliminating unhelpful medications, often through a medication taper; dose adjustments based on pharmacokinetic parameters; therapeutic and adverse responses to medication; initiation of medications for symptom control; education of patients about safe drug use, tolerance, dose ceiling effects, toxicities and alternative methods of managing their symptoms.
Pharmacists also provide drug information to the professional staff and patients and conduct periodic in-service education programs for the staff on new pharmacological issues related to pain management. As part of the interdisciplinary team, residents will be expected to participate in the education and training of Doctor of Pharmacy students from the College of Pharmacy, Anesthesiology residents, Anesthesiology Pain Management Fellows, and Medical students.
Additional Resident Requirements during the Rotation:
Each resident attend weekly and make a 30 minute clinical presentation to the interdisciplinary Pain Research Center Didactic session that occurs every Friday morning form 7:00-8:30 AM. Residents also are encouraged to develop case reports or reviews for publication consideration in the refereed literature.
