Pain management should include continuous therapy and the use of PRN treatment should only be available to assist in dose escalation. Special considerations should be given in dosing to Morphine Milligram Equivalents and serotonin syndrome. Both the CDC and HHS released new guidelines for reducing the burden of chronic pain in the United States in March 2016. Outpatient procedure clinics have significantly reduced the need for non-steroidal therapies in the elderly.
Prescription Monitoring Programs are in use in most states and controlled substance agreements may be coming to long-term care environments. Narcotic use in the elderly requires careful management of constipation and of falls risk. This presentation will also address the interface between pain management and the principles of addiction medicine. One principle currently gaining traction is to keep opioid naive patients naive.
Review the pathogenesis of pain
Apply recent guidelines in pain management
Choose appropriate drug therapy and multimodal interventions for the relief of pain
Enroll in your state's Prescription Drug Monitoring Program (PDMP)
Balance the management of patients who present with both pain and opioid addiction
Speaker disclosures: All members of the education and online education committees have no financial relationships to disclose. Dr. Tangalos has no financial relationships to disclose.
Brief summary: This presentation will include the evaluation and treatment of chronic non-malignant pain in post-acute, long-term care and primary care settings. Dramatic changes have occurred since the Joint Commission first declared that Pain was the “Fifth Vital Sign” in 2007. The opioid epidemic is unique to America and is being addressed on a variety of fronts. AMDA and the AMA now support removal of the Pain Scores from Quality Metrics reporting and the Five Star rating system.
Credit information: AMDA - The Society for Post-Acute and Long-Term Care Medicine (The Society) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education for physicians. The Society designates this live activity for a maximum of 1.5 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.