Marian Wilson, PhD, an assistant professor at the Washington State University College of Nursing, is joining a team of scientists who’ll lead a $2.5 million study that will investigate whether an online pain management program can help patients with chronic pain reduce or eliminate the amount of prescription opioids they take, according to a news release.
Wilson is a co-investigator on the EMPOWER study with lead investigator Theresa Winhusen, director of the Addiction Sciences Division in the University of Cincinnati College of Medicine. The five-year study will involve 400 non-cancer patients who are being treated for chronic pain with long-term opioid therapy at University of Cincinnati Health and Duke Health.
A web-based pain management tool, called Goalistics Chronic Pain Management Program, has been found in small previous trials to decrease patients’ pain and reduce opioid use. The study will expand the sample size, and researchers will have access to patients’ clinical records to accurately measure opioid use.
According to the Goalistics website, the program uses a variety of electronic tools to provide a foundation for learning. These tools include DVDs, online assessments, interactive learning, electronic messaging, in-stream video, online discussion forums and online data tracking and graphing. Features such as self-assessment, homework exercises and self-monitoring can be created to suit the specific goals of a program.
Goalistics teaches relaxation exercises and psychological approaches to managing pain, and encourages goal-setting and physical activity.
The EMPOWER study hopes to give primary care providers another method to use in helping patients manage chronic pain, while also responding to soaring opioid addiction rates and overdose deaths. The Centers for Disease Control and Prevention has recommended decreasing the use of opioids for treating pain.
According to CDC Guideline for Prescribing Opioids for Chronic Pain, an estimated 20% of patients presenting to physician offices with non-cancer pain symptoms or pain-related diagnoses (including acute and chronic pain) receive an opioid prescription. In 2012, healthcare providers wrote 259 million prescriptions for opioid pain medication, enough for every adult in the United States to have a bottle of pills.
“It’s a really difficult situation telling people, ‘Sorry, you can’t have your opioids, but we’re not really giving you an alternative,’” Wilson said in the news release. An online pain management program could be “a lifeline extended to patients, another tool to help manage pain. It’s something that can give them some hope and show that people understand what they’re going through.”
The research is being funded by the National Institute on Drug Abuse, part of the National Institutes of Health. Wilson said she’ll function as the study’s pain and online-program expert, while Winhusen, the lead investigator, will oversee the clinical trial.
60227: Interprofessional Guide to Pain Management (6 contact hrs)
Pain is experienced by almost all patients regardless of age or sex. Virtually all health professionals help patients who are experiencing pain, and physicians, nurses, therapists, psychologists, pharmacists and social workers can specialize in pain management. Thus, no single discipline completely understands pain, and how or why it manifests in individual patients. To provide comprehensive team-based care, professionals must understand the limits of their own expertise, while gaining insight from and an appreciation for that of other disciplines. This requires health professionals to collaborate to better assess, understand and manage patients with complex pain. By working together for the common goal of developing an effective, safe, comprehensive patient-centered treatment plan, patients with pain who don’t respond to usual treatments can have more positive outcomes.
CE442: Knocking Out Pain Safely with PCA
(4.00 contact hrs)
For many postoperative patients, patient-controlled analgesia is the primary source for managing pain. The basic design of PCA includes a computerized pump that can deliver several medications, such as morphine, hydromorphone or fentanyl, according to an order written by a physician, nurse practitioner or physician assistant. Prescribers’ orders should clearly define the medication, dose, dosing interval, monitoring parameters, the one- or four-hour lockout total and the maximum dose of medication the patient can use in those time periods. PCA is not without risks. Nurses who understand the risks of PCA therapy will take all measures needed to ensure that patients are protected from PCA errors and receive excellent pain control. This module will discuss the use, benefits and risks of PCA and nurses’ responsibilities in caring for patients using PCA.
CE702: Responsible Opioid Prescribing, Chronic Pain and Addiction (1.5 contact hrs)
The increased emphasis on management of pain to improve quality of life and functionality of people with chronic pain has contributed to a significant increase in the number of opioid prescriptions being written. With increased availability of prescription pain medicine, there has been an increased risk of misuse and abuse. This educational activity will address issues related to the regulation, medical management, misuse, abuse and diversion of controlled substances.