Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Dec 2022
Impact of Clinical Pharmacist Practitioner-Driven High Opioid Dose Reevaluation in Veterans with Chronic Non-Cancer Pain.
Veterans Health Administration implemented the Opioid Safety Initiative (OSI) in 2013 to promote safe/rational opioid prescribing. West Palm Beach VA Healthcare System (WPBVAHCS) has been an outlier for the percentage of Veterans with chronic non-cancer pain receiving ≥90 mg Morphine Equivalent Daily Dosing (MEDD) in Veterans Integrated Service Networks (VISN) 8 since the 2016 fiscal year. The purpose was to determine the utility of a Pain Clinical Pharmacist Practitioner (CPP) identifying, reviewing, and approaching Veterans utilizing high-dose opioids for dose reevaluation and the impact on OSI metric post-opioid reevaluation. ⋯ No documented opioid overdose events, hospitalizations for uncontrolled pain or mental health, suicide attempts or pain-related crisis interventions were reported. Pain CPP's are equipped to provide opioid education, address risk mitigation strategies, reassess pain regimens, and refer for non-pharmacologic modalities. Utilization of Pain CPP resources helps improve OSI metrics while providing safe comprehensive medication management (CMM) for chronic pain.
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J Pain Palliat Care Pharmacother · Sep 2022
Evaluating Outcomes of a Pharmacist-Driven Pain Management Consult Service.
The opioid crisis continues to place a significant burden on American families and the healthcare system. To date, there is an evolving body of evidence demonstrating that pharmacists can positively impact patient care in the pain management specialty. ⋯ Additionally, there was a statistically significant reduction in the number of morphine milligram equivalents (MMEs) at 48 hours post consult (149.4 vs. 133.8; p < 0.001; Table 4) and 24 hours prior to discharge (136.5 vs. 100.6; p < 0.001; Table 4) when compared to 24 hours prior to consult. This pharmacist-driven pain consult service demonstrated a statistically significant reduction in pain scores while simultaneously reducing MME utilization and the number of opioids ordered, using a multimodal evidence-driven approach to pain management in a community hospital.
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J Pain Palliat Care Pharmacother · Sep 2022
Case ReportsLucid Dreams Associated with Pregabalin: Implications for Clinical Practice.
Here, we describe a case of a patient with multiple myeloma who reported symptoms of lucid dreams. This patient was taking methadone for neoplasm related pain. The patient was also taking pregabalin which was initially started at dosing of 50 mg taken orally three times a day. ⋯ Resolution of the lucid dreams occurred following discontinuation of pregabalin. To our knowledge, this is the first reported case of an association between pregabalin and lucid dreams. Given that pregabalin is a widely used medication, we found this case to be relevant to describe this unique presentation.