Pain Management and Opioid Free Treatment Order Sets: An Evolving Role for Pharmacists

Over the past twenty five years, significant changes to the assessment and treatment of pain have occurred. In the 1990s, the identification of "pain as the fifth vital sign" impacted how providers assessed and treated pain. Now, with the opioid epidemic and recommendations from multiple organizations to remove pain as the fifth vital sign, the practice of pain management is changing again. Despite these changes, pain is still a common condition many patients experience. It is estimated about 50% of older adults in the community report daily pain, and there is an increased prevalence of pain in the facility setting, with 45-80% of residents reporting chronic pain impacting their quality of life. With the growing number of older adults in the United States, pharmacists working with geriatric patients need to be familiar with the treatment of pain and new approaches that are being utilized.