The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists
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Outline the key points and list the criteria for compliance with the new Centers for Medicare & Medicaid Services (CMS) pain management at F-Tag 309. ⋯ In March 2009, CMS implemented revised guidelines for long-term care surveyors at F-Tag 309, Quality of Care, including a new general investigative protocol and pain-management guidance. While the regulations have remained the same, the way surveyors interpret pain management has changed. By understanding the criteria surveyors will use to determine F-Tag 309 deficiencies, consultant pharmacists can educate other interdisciplinary team members to improve pain management practices in long-term care.
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Evaluate the efficacy and safety of pharmacological pain management treatments to minimize adverse events and optimize pain relief. ⋯ Pain is a common problem among elderly long-term care residents and is vastly undertreated. Even when pain medication is prescribed, often residents do not receive the most appropriate drug, or prescribers fail to adjust the dose and frequency of administration to tailor therapy to the individual's compromised physiology and needs. This places elders at risk, for not only unnecessary suffering, but also for drug toxicity. Consultant pharmacists are in a key position to identify underuse and inappropriate use of analgesic drugs and assist prescribers with individualizing each resident's medication regimen to provide optimal therapeutic outcomes.
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Summarize practical strategies for recognizing and assessing pain in the long-term care population, particularly for cognitively impaired residents. ⋯ Pain that is under-recognized and undertreated can result in significant physical and social disability in the elderly long-term care population. Proper assessment of pain is needed to diagnose and determine an appropriate and individualized treatment plan for each resident. Consultant pharmacists play critical roles as medication experts and members of the long-term care interdisciplinary team that can assist other team members in the assessment, treatment, and management of pain in older adults.