Category:Chronic Pain: Difference between revisions

Revision as of 23:54, 14 February 2019

Tips for managing chronic pain

Above is a link to a pdf for "10 Steps to Managing Chronic Pain"

Outpatient/SRC Clinic Controlled Medication Management Policies

The Pain Committee is an interdisciplinary committee constructed to adopt the responsibility of pain management for our chronic pain patients, effectively removing individual provider responsibility for e.g., discontinuing a pain contract.
Any provider may refer a patient to the Pain Committee by placing a referral in PowerChart/FirstNet (Refer to Pain Committee Internal)
Questions regarding pain management issues should be referred to the Chronic Pain Pharmacist, not to individual providers.
The Chronic Pain Pharmacist will assist in tracking refills, strikes, expired pain agreement etc.
To help reduce the call burden on providers, patients calling with questions about narcotic refills should be referred to the pharmacy.
Letters regarding pain management will only be sent out by the Pain Committee, not by individual providers. Any communication regarding agreements being cut off, or warnings really need to come from that entity, not from any specific provider.
The Pain Committee, not individual providers, will be in charge of monitoring pain contracts, contract infractions (i.e., strikes), and keeping records. Any information about a positive drug screen etc., can be forwarded to our Chronic Pain Pharmacist.
Providers are not responsible for monitoring illegal drug activity. That is a law enforcement issue. Our job as health care providers is to provide compassionate treatment for our patients. Some of the patients will do illegal things with their medication, but let the law enforcement experts deal with that. If you suspect that diversion is occurring, you can report it to the Bethel PD or State Troopers (for villages) and they can investigate.
SRC providers may do pain contracts if needed, but may also refer patients to the Pain Committee for recommendations if there are questions. If there are patients who are requesting long term narcotics that you feel uncomfortable with, do not prescribe them and feel free to refer that patient to the Pain Committee.
We also have a Suboxone Program for opioid use disorder and you may refer patients for an assessment by the Opioid MAT at 543-6772 (Opioid Case Manager).

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 ==Outpatient/SRC Clinic Controlled Medication Management Policies==
-. All providers are always able to refer patients to the pain committee. Order a refer to PAIN COMMITTEE in RAVEN or message the pharmacists – Michael Stamper /Jason Byrd.
+#The Pain Committee is an interdisciplinary committee constructed to adopt the responsibility of pain management for our chronic pain patients, effectively removing individual provider responsibility for e.g., discontinuing a pain contract.
+#Any provider may refer a patient to the Pain Committee by placing a referral in PowerChart/FirstNet ('''Refer to Pain Committee Internal''')
-. Any patient questions regarding pain management issues should be referred to the Bethel case management team- not individual providers. If patients call an SRC or questions about their meds and prescription refills they need to call the pharmacy and Alan Miller 543-6652.
+#Questions regarding pain management issues should be referred to the Chronic Pain Pharmacist, not to individual providers.
+#The Chronic Pain Pharmacist will assist in tracking refills, strikes, expired pain agreement etc.
-We are trying to decrease the burden of multiple phone calls about refills and questions on you and let pharmacy assist  with it.
+#To help reduce the call burden on providers, patients calling with questions about narcotic refills should be referred to the pharmacy.
+#Letters regarding pain management will only be sent out by the Pain Committee, not by individual providers.  Any communication regarding agreements being cut off, or warnings really need to come from that entity, not from any specific provider.
-.  Letters regarding pain management will only be sent out by the pain committee, not by individual providers. The pain committee is an interdisciplinary committee constructed to take away any individual responsibility in the pain decisions regarding our patients.  Any communication regarding agreements being cut off or warnings really need to come from that entity – not from any specific provider.
+#The Pain Committee, not individual providers, will be in charge of monitoring pain contracts, contract infractions (i.e., strikes), and keeping records. Any information about a positive drug screen etc., can be forwarded to our Chronic Pain Pharmacist.
+#Providers are not responsible for monitoring illegal drug activity.  That is a law enforcement issue.  Our job as health care providers is to provide compassionate treatment for our patients.  Some of the patients will do illegal things with their medication, but let the law enforcement experts deal with that.  If you suspect that diversion is occurring, you can report it to the Bethel PD or State Troopers (for villages) and they can investigate.
-. The Pain committee will be in charge of monitoring all strikes and keeping excel spreadsheets - not individual providers. This again is to allow case managers who have the time to track and monitor these patients. Any information about a positive drug screen etc can be forwarded to Pharmacy – Michael Stamper/Jason Byrd our narcotic pharmacists.
+#SRC providers may do pain contracts if needed, but may also refer patients to the Pain Committee for recommendations if there are questions.  If there are patients who are requesting long term narcotics that you feel uncomfortable with, do not prescribe them and feel free to refer that patient to the Pain Committee.
+#We also have a Suboxone Program for opioid use disorder and you may refer patients for an assessment by the '''Opioid MAT at 543-6772 (Opioid Case Manager)'''.
-. Providers are not responsible for monitoring the illegal drug activity in their villages – that is a law enforcement issue. Our job as health care providers is to provide compassionate treatment of our patients. Some of the patients will be do illegal things with their medication. Let the law enforcement experts deal with that.  If you feel that diversion is occurring – you can report it to the troopers – they can further investigate it.
-.  Patients who are uncooperative or harassing with staff will be given a strike.  This will be added to the controlled medicine agreement guideline.
-. SRC providers will do pain contracts if needed - but whenever needed will refer to the Pain Committee for recommendations if there are questions.   If there are patients who are requesting long term narcotics that you feel uncomfortable with – do not prescribe them and feel free to refer that patient to the pain committee.   Pharmacy will assist him in tracking refills and strikes, expired pain agreement etc.
-. Each SRC provider should only be scheduled one controlled medicine contract a day and it should a 30 appointment.
-. Patients on Kadian/Oxycontin/MS Contin who do not like it will be instructed to lower their dose as recommended by pharmacy and try that for several months.  Patients will not be switched after a one month trial of Kadian/Oxycontin/MS Contin back to their short term narcotics without a long term trial of Kadian.