Impact of a Pharmacy-Led Pain Management Team on Adults in an Academic Medical Center

药房主导的疼痛管理团队对学术医疗中心成年患者的影响

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Abstract

Background: Pain is a major health problem affecting more than 15% of adults in the United States. In a multidisciplinary pain management team, pharmacists can optimize pharmacotherapy quality by ensuring safe and appropriate medication use. Objective: Assess the impact of a pharmacy pain medication management service on pain-related outcomes in an adult inpatient population. Methods: This retrospective study evaluated patients who were admitted from November 2009 through November 2011 and received a pharmacy pain consult. Patients were excluded if they left against medical advice, their care was assumed by palliative care, or they had no complaint of pain when seen by the pharmacist. The primary outcome was the difference between each patient's average pain score from pre-consult to post-consult. Secondary outcomes were difference between each patient's average pain score from pre-consult to pre-discharge, overall functional improvement, pharmacist interventions, and 14-day and 30-day readmissions. Results: One hundred patients were included in the final analysis. Eight hundred twenty-one interventions were made by the clinical pharmacists. Patients displayed a significant reduction in their pre- and post-consult pain intensity scores on a 0 to 10 numerical rating scale (6.15 vs 3.25; p < .001). Likewise, a significant reduction in pain intensity scores was seen from pre-consult to pre-discharge (6.15 vs 3.6; p < .001). Overall functional improvement, specifically sleep, mobility, and appetite, was seen in 86.6% of patients. Conclusions: Pain management is an area that provides opportunities for pharmacotherapy interventions. Pharmacists' involvement in pain management on an inpatient consult service had a positive impact on pain scores and improvement in functionality.

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