Pain management pharmacy service in a community hospital

The implementation of a pain management pharmacy service in a community hospital is described.

The medical staff at Saint John's Health Center (SJHC) in Santa Monica, California, decided that one of the steps toward the goal of appropriate and adequate analgesia was the addition of a full-time pain management pharmacist (PMP) in 1999 along with a new pain physician. In preparation for the PMP position, the PMP attended conferences and continuing- education seminars on the treatment of acute and chronic pain. The PMP also conducted daily patient rounds with the pain physician. The daily responsibilities of the PMP include printing a daily list of patients using patient-controlled analgesia (PCA), making rounds for all patients receiving PCA, and completing an initial review and evaluation of the patient within 24 hours of starting PCA. In addition, the PMP is responsible for providing recommendations to the attending physician if the patient's pain control is inadequate or if intolerable adverse effects are noted and documenting these recommendations in the physician's progress notes, providing education to the patient regarding PCA use, and recommending a consultation with the pain physician in complicated cases. In the eight-year period that the PMP service has been established, the number of PCA patients has progressively increased more than 50%, from approximately 1200 PCA patients per year in 1999 to 1710 in 2007.

The pharmacy department at a community hospital successfully implemented a pain management program. The PMP provided pain management services to patients and a valuable resource to other health care staff.