Pain Care Essentials

Edited by Beth B. Hogans and Antje M. Barreveld

Follows IASP-endorsed guidelines on interprofessional pain care
Case-based structure to assist in applying basic pain care concepts to patient care
Comprehensive resource for educators, students and post-graduates on the basics needed to provide compassionate, multimodal pain care
Supplies guidance on safe opioid prescribing and non-opioid management options

Pain Care Essentials

Edited by Beth B. Hogans and Antje M. Barreveld

Description

It may come as something of a surprise that pain, the most prevalent symptom in clinical practice, is not always addressed specifically in health professions training. Approximately one in six Americans lives with chronic pain in addition to the millions that experience acute pain each day. Half of older adults live with chronic pain-associated conditions, and about half of all healthcare visits are initiated because of pain. Despite this, reports indicate that the vast majority of health professions schools in the United States do not teach required courses on pain, and the total amount of content pertaining to pain is a fraction of a percent of the total. Almost certainly, the lack of education in coordinated, comprehensive, compassionate care for pain-associated conditions contributed to pervasive opioid over-prescribing and the ensuing wave of addiction and deaths that swept the country in the first part of this century. This book is our response to the pain care crisis - it is designed to prepare young clinicians to assess and treat a wide variety of pain conditions in a manner that balances competence and compassion, incorporating coordinated elements of pharmacological and non-pharmacological therapies.

Designed to be read during or after pre-licensure training, e.g. medical, nursing, pharmacy school, and to inspire students to learn more about painful conditions, this book is unique in its clinical focus and the level of detail that is included. This book aims to improve pain care, most especially if used alongside a formal pain care course as part of pre-licensure training, whether spread over four years or condensed into a shorter period. Through engagement in the interprofessional curriculum planning process, the content of the book has been shaped to align with the International Association for the Study of Pain (IASP) interprofessional pain curriculum vision and to focus on the primary questions of: What is pain? How is pain assessed? How is pain managed? How does clinical context influence pain?

Pain Care Essentials

Edited by Beth B. Hogans and Antje M. Barreveld

Introduction
Part I: The Multidimensionality of Pain: Neurobiology, Scope, and Impact
1. Pain pathways: Structural organization and development
2. Nociceptive processing: Neurochemistry and neurophysiology
3. The impact of pain: Epidemiology, economics, cultural influences, ethics
4. The appraisal of pain: Measurement, classification, and nomenclature
5. The spectrum of pain experience
Part II: Clinical Skills in the Assessment and Care of Pain
6. Clinical assessment of pain: The pain narrative, examination, clinical stance
7. Diagnostic reasoning in the pain-focused encounter
8. Professionalism in pain care: Compassion, decision-making, behavior change difficult conversations, ethical standards, pain self-management
Part III: Pain Treatments and Approaches to Management
9. Pharmacological treatments I: Standard systemic analgesic agents
10. Pharmacological treatments II: Anti-depressants, anti-convulsants, etc.
11. Interventional and surgical management of pain
12. Rehabilitational approaches to pain and applications in outpatient practice
Part IV: Pain Care in Clinical Context
13. Pain emergencies and life-threatening complications of pain treatments
14. Acute pain: Peri-operative, trauma-related, and obstetric pain
15. Urgent pain problems (migraine, acute lower back pain, etc)
16. Common chronic pain-associated conditions (neck pain, lower back pain, neuropathy)
17. Extremes of pain: CRPS, trigeminal neuralgia, congenital pain insensitivity
18. Pediatric pain
19. Pain in older patients
20. Pain, addiction, and psychiatric illness
Appendices: Commonly used pain medications; Adjustments for liver and renal failure; Opioid conversion table; Exam template; Integrated back pain flow diagram

Pain Care Essentials

Edited by Beth B. Hogans and Antje M. Barreveld

Author Information

Edited by Beth B. Hogans, Associate Professor; Director of Pain Education, Department of Neurology, Johns Hopkins School of Medicine, and Antje M. Barreveld, Clinical Fellow in Anaesthesia, Brigham and Women's Hospital

Dr. Beth B. Hogans, M.D., Ph.D. holds board certifications in Neurology, Clinical Electrophysiology, and Pain Medicine and is an experienced general and peripheral neurologist with a strong focus on providing patient-centered care. Dr. Hogans teaches medical students about pain management at Johns Hopkins School of Medicine where she is an associate professor of neurology. She is a 2018 recipient of the Osler Attending Teaching Preceptor designation in the Johns Hopkins Neurology Department. Antje Barreveld, MD is Assistant Professor of Anesthesiology at Tufts University School of Medicine, Medical Director of Pain Management Services, Director of Education and Outreach for the Substance Use Services, and Anesthesiologist with Commonwealth Anesthesia Associates at Newton-Wellesley Hospital in Newton, MA. Dr. Barreveld is also a Clinical Researcher at Harvard Medical School in the Department of Anesthesiology, Perioperative and Pain Medicine at Brigham and Women's Hospital in Boston,

MA. Her clinical, leadership, and research interests are in pain management education, chronic pelvic pain in men and women, acute and chronic postoperative pain, and safe practices in co-managing pain and addiction. Her goal is to inspire interprofessional students to recognize the joy of alleviating suffering - and that safe, effective pain management is an achievable goal for all new clinicians.

Contributors:

Bernard Abrams, MD
Department of Physical Medicine and Rehabilitation
Johns Hopkins School of Medicine
Baltimore, MD
Christopher R. Abrecht, MD
Department of Anesthesia & Perioperative Care
Division of Pain Medicine
University of California San Francisco
San Francisco, CA
Paul Arnstein, RN, PhD, FAAN
Massachusetts General Hospital
Boston, MA
Antje M. Barreveld, MD
Medical Director, Pain Management Service
Department of Anesthesiology
Newton- Wellesley Hospital, Tufts University School of Medicine
Newton, MA
Staja Q. Booker, PhD, RN
Postdoctoral Fellow
University of Florida
Gainesville, FL
Matthew Digiusto, MD
Department of Anesthesiology and Critical Care Medicine
Department of Pediatrics
Johns Hopkins Hospital
Baltimore, MD
Susan G. Dorsey, PhD, RN, FAAN
Professor and Department Chair
Department of Pain and Translational Symptom Science
University of Maryland, School of Nursing
Baltimore, MD
Marlis Gonzalez- Fernandez, MD, PhD
Department of Physical Medicine and Rehabilitation
Johns Hopkins School of Medicine
Baltimore, MD
Keela A. Herr, PhD, RN, AGSF, FAAN
Kelting Professor in Nursing and Associate Dean for Faculty
University of Iowa, College of Nursing
Iowa City, IA
Beth B. Hogans, MS, MD, PhD
Associate Professor and Director of Pain Education
Department of Neurology
Johns Hopkins School of Medicine
Associated Director for Education and Evaluation
Geriatric Research, Education, and Clinical Center
VA Maryland Health Care System
Baltimore, MDx

Valerie Jackson, PhD, MPH
Department of Anesthesia and Perioperative Care
University of California, San Francisco, Pain Management Center
San Francisco, CA
Robert N. Jamison, PhD
Departments of Anesthesia and Psychiatry
Harvard Medical School,
Brigham and Women's Hospital
Boston, MA
Megan Keating, RN- BC, BSN
Massachusetts General Hospital
Boston, MA
Benjamin S. Kematick, PharmD
Clinical Pharmacy Specialist, Palliative Care
Dana- Farber Cancer Institute
Boston, MA
Marc O. Martel, PhD
Faculties of Dentistry and Medicine
McGill University
Montreal, Quebec, Canada
Michele L. Matthews, PharmD, CPE, BCACP, FASHP
Associate Professor of Pharmacy Practice
Massachusetts College of Pharmacy and Health Science
Advanced Practice Pharmacist, Pain Management
Brigham and Women's Hospital
Boston, MA
Amira Noles, MD
Johns Hopkins School of Medicine
Department of Physical Medicine and Rehabilitation
Baltimore, MD
Tommy Rappold, MD
Department of Anesthesiology and Critical Care Medicine
Department of Pediatrics
Johns Hopkins Hospital
Baltimore, MD
Cynthia L. Renn, PhD, RN
Associate Professor
Department of Pain and Translational Symptom Science
University of Maryland, School of Nursing
Baltimore, MD
Andrew Rubens, MD
Department of Anesthesiology
Newton- Wellesley Hospital
Newton, MA
Kristin Schreiber, MD, PhD
Professor of Anesthesia
Chief, Division of Pain Medicine
Department of Anesthesia and Perioperative Care
University of California, San Francisco
San Francisco, CA

Mark Schumacher, PhD, MD
Professor of Anesthesia
Chief, Division of Pain Medicine
Department of Anesthesia and Perioperative Care
University of California, San Francisco
San Francisco, CA
M- Irfan Suleman, MBBS, MD
Department of Anesthesiology and Critical Care Medicine
Kennedy Krieger Rehabilitation Institute
Baltimore, MDYi Cai Isaac Tong, MD
Pain Medicine Physician
Tricity Pain Associates
San Antonio, TX
Katherine S. Wright, PhD
Department of Physical Medicine and Rehabilitation
Johns Hopkins School of Medicine
Baltimore, MD
Ada L. Yao, MD
Department of Physical Medicine and Rehabilitation
Johns Hopkins School of Medicine
Baltimore, MD
R. Jason Yong, MD, MBA
Medical Director, Brigham and Women's Pain Management Center
Brigham and Women's Hospital/ Harvard Medical School
Boston, MA
Mark Young, MD
Department of Anesthesiology
Newton- Wellesley Hospital
Newton, MA
Nantthasorn Zinboonyahgooon, MD
Chief, Division of Pain Medicine
Siriraj Hospital