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Clinical Corner: Pain Management

Latest News

  • Working with the FDA, Purdue has developed a Risk Evaluation and Mitigation Strategy (REMS) for Butrans (buprenorphine) Transdermal System. Please see the Dear Healthcare Provider Letter
    www.butransrems.com/pdf/HCPL%20BUTRANS%20letter.pdf

  • Tramadol hydrochloride - Strengthened warnings emphasize the risk of suicide for patients who are addiction-prone, taking tranquilizers or antidepressant drugs and also warns of the risk of overdosage. www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm213264.htm

  • The FDA announced that it will be removing Propoxyphene (Darvon and Darvocet) from the market due to the potential risk for fatal heart rhythm abnormalities. See www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm234350.htm for details.

  • “Dear Healthcare Professional” letter informing physicians, nurses and pharmacists of important information for patients prescribed OxyContin® (oxycodone HCl controlled-release) Tablets CII.  www.purduepharma.com/pdfs/dearHCPletter.pdf.



    Important New REMS Information

    Purdue Pharma, L.P. is introducing a Risk Evaluation and Mitigation Strategy (REMS) for OxyContin® (oxycodone HCl controlled-release) Tablets CII to educate physicians and other prescribers, pharmacists, patients, and caregivers about the potential for abuse, misuse, overdose, and addiction from exposure to OxyContin® Tablets.

    The goals of the OxyContin® REMS program are:

    • Goal 1. To inform patients and healthcare professionals about the potential for abuse, misuse, overdose, and addiction of OxyContin®
    • Goal 2. To inform patients and healthcare professionals about the safe use of OxyContin®

    For more information go to: www.OxyContinREMS.com or the FDA website.



    Articles

    Pain Tolerance and Obstructive Sleep Apnea in the Elderly (Journal of the American Medical Directors Association, October 2010)

    Pain and Its Treatment in Older Nursing Home Hospice/Palliative Care Residents (Journal of the American Medical Directors Association, October 2010)

    End-of-Life Care in the Nursing Home(Journal of the American Medical Directors Association, September 2010)

    End-of-Life Care in Nursing Homes: The Importance of CNA Staff Communication (Journal of the American Medical Directors Association, September 2010)

    Evaluation of a Continuous Quality Improvement Initiative for End-of-Life Care for Older Noncancer Patients (Journal of the American Medical Directors Association, August 2010)

    An Action-Based Approach to Improving Pain Management in Long Term Care (Journal of the American Medical Directors Association, March 2010)

    Are You Ready for Pain Management Under F-Tag 309? (Journal of the American Medical Directors Association, March 2010)

    End of Life Care in the Nursing Home Setting (Journal of the American Medical Directors Association, March 2010)

    Pain Control Among Patients Admitted to Nursing Home. How are we Doing? (Journal of the American Medical Directors Association, March 2010)

    Perceptions of the Nurse Practitioner Role around Pain Management in Long Term Care (Journal of the American Medical Directors Association, March 2010)

    Pain Assessment in Nursing Home Residents With Dementia: Psychometric Properties and Clinical Utility of the CNA Pain Assessment Tool (CPAT) (Journal of the American Medical Directors Association, September 2009)

    Prn Pain Medication Protocol for Chronic Pain in a LTC Setting (Journal of the American Medical Directors Association, March 2009)

    Implementing a Pain Management Program in a Long-Term Care Facility Using a Quality Improvement Approach (Journal of the American Medical Directors Association, January 2009)

    Who Suffers Most? Dementia and Pain in Nursing Home Patients: A Cross-sectional Study (Journal of the American Medical Directors Association, July 2008)

    Initiating and Sustaining a Standardized Pain Management Program in Long-Term Care Facilities (Journal of the American Medical Directors Association, June 2008)

    Substantial Daily Pain Among Nursing Home Residents (Journal of the American Medical Directors Association, March 2007)

    The Application of Evidence-Based Principles of Care in Older Persons (Issue 4): Pain Management (Journal of the American Medical Directors Association, October 2006)

    A Standardized Quality Assessment System to Evaluate Pain Detection and Management in the Nursing Home (Journal of the American Medical Directors Association, March 2006)

    Measuring Pain Presence and Intensity in Nursing Home Residents (Journal of the American Medical Directors Association, March 2006)

    Nursing Home Resident Barriers to Effective Pain Management: Why Nursing Home Residents May Not Seek Pain Medication (Journal of the American Medical Directors Association, March 2006)

    Barriers to Managing Pain in the Nursing Home: Findings From a Statewide Survey (Journal of the American Medical Directors Association, May 2005)

    Methods of pain assessment in residents of long-term care facilities: A pilot study (Journal of the American Medical Directors Association, March 2005)

    Effective Pain Management in the Long-Term Care Setting (Journal of the American Medical Directors Association, September 2004)

    Palliation Issues in LTC (Caring for the Ages, August 2004)

    Pain Barriers (Caring for the Ages, June 2004)

    Vital Sign #5 (Caring for the Ages, May 2004)

    The Policies of Pain (Caring for the Ages, August 2003)

    Pain in the Elderly: Listen to the Patient's Voice (Caring for the Ages, April 2003)

    Courts Weigh In on Use of Drugs for Assisted Suicide & Pain Management (Caring for the Ages, September 2002)

    Pain Management in End-of-Life Care: Are We Meeting Our Dying Patients' Needs? (Caring for the Ages, July 2002)

    Opioids Can Safely Ease Chronic Non-Malignant Pain (Caring for the Ages, July 2002)

    Challenges in Pain Management Among Persons with AIDS in a Long-Term-Care Facility (Journal of the American Medical Directors Association, March 2002)

    The Functional Pain Scale: Reliability, Validity, and Responsiveness in an Elderly Population (Journal of the American Medical Directors Association, March 2002)

    Protocol Pinpoints Discomfort in Late-Stage Dementia Patients (Caring for the Ages, October 2001)

    Toward a Good Death in the Nursing Home: Pain Management & Hospice are Key (Caring for the Ages, July 2001)

    Tools and Resources

    Geriatric Care- Tools for Nurses caring for adults with pain in nursing homes

    In The Face of Pain

    Nursing Standard of Practice Protocol: Pain Management in Older Adults

    Pain Assessment tools

    Partners Against Pain

    The Management of Persistent Pain: Resources for Older Adults and Caregivers (for Assisted Living and community based adults)

    Clinical Practice Guideline News: Pain Management

    Symptom Acuity Graph

    Reference Bibliography

    Products & Publications

    Pain Management in the Long-Term Care Setting (AMDA Clinical Practice Guideline revised 2009)

    Tool Kit for Implementation of the Clinical Practice Guideline for Pain Management (AMDA CPG Implementation Tool kit published 2004)

    Links

    American Academy of Pain Management

    American Pain Society

    International Association for the Study of Pain®

    Opioid conversion calculator

    Worldwide Congress on Pain

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