Journal of pharmacy practice
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Pain continues to be a serious health care concern in the United States. Patients with chronic pain experience the impact of the disease throughout their lives including their social interactions, family relationships, and in many cases economic productivity. Multiple surveys have found that many pharmacists hold misconceptions regarding opioids, pain disease states, and their understandings of current regulations. ⋯ Inadequate communication between health care professionals and patients is one of the hurdles, which prevents quality care. Increased communication between health care providers including access to health information is one step, which is crucial to improving provision of pharmacotherapy. Finally, the quality of educational opportunities relative to opioids and pain management specifically for pharmacists needs to be increased, and consideration needs to be given for making appropriate pain management education mandatory.
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Extended-release oral and transdermal opioids are increasingly being used for the management of chronic pain. Although the dosing intervals for these products were established through controlled clinical trials, expanded use of extended-release and transdermal dosage forms has resulted in awareness that a significant number of patients with chronic pain experience loss of baseline pain control prior to the next scheduled dose. End-of-dose failure (EDF) is the term used to describe this type of pain manifestation. By recognizing potential causes of EDF, strategies may be developed to overcome its occurrence to improve patients' pain control.
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With the increased focus on improving patients' pain control and upward trends in opioid overdose and deaths, health care professionals have become increasingly interested in reducing their professional risks and improving the safety of their patients receiving chronic opioids. These fears can often be further exacerbated by media attention of deaths from opioid misuse or unintentional overdose and physician prosecution for 'overprescribing' of controlled substances, including opioids. ⋯ In addition, it describes the important differences between abuse, addiction, physical dependence, and tolerance. Sample informed consent for chronic opioid therapy and patient-provider agreements are included.
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A credential is documented evidence of a pharmacist's qualifications; while credentialing is the method used to acquire, confirm, determine, and document a pharmacist's qualifications to practice. Voluntary credentials are important in clinical pharmacy specialties to ensure proficiency in caring for patients with complex pharmacotherapy needs. ⋯ A palliative care credentialing exam is not currently available to pharmacists. Efforts are underway within the pharmacy profession to standardize the board certification process, design a pain and palliative certificate program, and create a specialty pain management and palliative care board certification examination.