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A Nation in Pain: Healing Our Biggest Health Problem

by Anna Schlissel, Pain Research Education and Policy Program (PREP), Tufts University School of Medicine

The Pain Research, Education and Policy Program (PREP) is honored to present Judy Foreman, nationally syndicated Health Columnist and Author, on Thursday, March 14, 4:00-5:30 PM in the Merritt Auditorium at Tufts Dental School. Ms. Foreman is a nationally syndicated medical journalist with 37 years of experience. She has covered a variety of health issues including fitness, aging, cancer, heart disease, pain, nutrition, numerous specific diseases and basic biological science.

The Pain Research, Education, and Policy Program invites students, alumni, health care professionals, clinical staff and faculty,  health communicators, public health advocates, and others to join us for Ms. Foreman’s informative and engaging lecture,  immediately followed by a panel discussion.

For more information about the event, please click here

Add comment March 6th, 2013

PREP Alumni and Faculty Happenings

Among MS-PREP alumni/ae, Hallie Greenberg is redesigning templates for patient-controlled IV and epidural analgesia at the Brigham and Women’s Hospital to enhance quality and safety of pain relief.  Gretchen Kindstedt is working with the Massachusetts Pain Initiative in its legislative outreach, and is on track to earn a second Master’s degree from our department – an MPH — in 2014. Ian Koebner is employed at the Pain Treatment Center at University of California at Davis, dividing his time between clinical acupuncture and interprofessional pain education.  Jessica Peck is growing her acupuncture practice in Maine.  Along with her MS-PREP Capstone preceptor, Jessica will teach at the 7th Annual Palliative Care Conference at Maine Medical Center in Portland in June.  Heather Thomson, working in Health Outcomes and Pharmacoeconomics at Endo, recently conducted a claims analysis with collaborators in New Mexico on the prevalence of chronic pain in patients with pulmonary disease, and will report the findings in 3 abstracts and 2 papers.

Among Certificate alumni/ae, Elizabeth Carpino is now Program Coordinator for ChildKind International.  Based at Boston Children’s Hospital and led by Neil Schechter (whose PREP lecture on ChildKind is viewable at our website), this program improves pediatric pain management worldwide by certifying healthcare institutions according to process and quality measures.  Kathleen Norris is pursuing further studies to be credentialed as both an Adult and a Geriatric Nurse Practitioner, with the goal of positively impacting long-term care pain management practices and policies.

Among PREP faculty, Academic Director Libby Bradshaw has now overseen conversion of 4 PREP courses to a blended onsite/online format. Kudos to Libby, the Course Directors (Richard Glickman-Simon, Ewan McNicol, Pam Ressler and Steve Scrivani), their excellent TAs (Ali Carter, Kelly Murphy and Phuong Nguyen) and the students embarking on this new approach.  Dan Carr recently testified on behalf of the American Society of Anesthesiologists at an FDA workshop on possible relabeling of opioid package inserts, and was elected VP for Scientific Affairs of the American Academy of Pain Medicine. Srdjan Nedeljkoviccontinues work on the BOLD (Back Pain Longitudinal Data) study evaluating outcomes of management of elderly patients with back pain. As Director of the Brigham and Women’s Pain Medicine fellowship, Serge will accept the Fellowship Excellence Award from the American Academy of Pain Medicine at its annual meeting in April. Pam Ressler attended the Narrative Medicine Workshop at Columbia University, led by Rita Charon, a national figure and pioneer in this area. Pam looks forward to using tools of narrative medicine to engage her students next summer in PREP232 (Ethical and Sociocultural Aspects of Pain).

Add comment February 14th, 2013

There’s an App for That!

by Pamela Katz Ressler, MS, RN, HN-BC, adjunct faculty, Pain Research, Education and Policy program,Tufts University School of Medicine

Congratulations to Pain Research, Education and Policy Program (PREP) student, Amy Vaz for an Amy Vaz Capstone Presentationinnovative and informative capstone project and presentation, Chronic Pain: The Good Day Diary.

As a nurse and through her studies within the PREP program, Amy saw an unmet need for those living with chronic pain. For her capstone, Amy envisioned a Smartphone application that would enable individuals with chronic pain to chronicle and track their “good” days. Amy explained that there are currently a number of products on the market that track pain and negative symptoms for chronic pain patients, but none that focus on good days or days with less pain. Amy plans to take her capstone project to the next level, by pursuing market research and product development.

Stay tuned for more from Amy Vaz.

 

Add comment January 15th, 2013

Communicating the Experience of Chronic Pain and Illness through Blogging

When one thinks of chronic or persistent pain one often thinks in terms of the biologic pathways of pain perception.  However, an important component of pain involves of the psychosocial aspects of coping with a chronic illness.  Disciplines across the health professions, including medicine, nursing, psychology, social work, and sociology, are actively engaged  in understanding the psychosocial and emotional consequences of chronic pain and illness: Yet few studies have addressed the  use of web-based tools, such as blogs, in the patient experience of living with chronic pain or illness.

Four Tufts University School of Medicine faculty members, Pamela Katz Ressler (Pain Research, Education and Policy Program), Libby Bradshaw (Pain Research, Education and Policy Program), Lisa Gualtieri (Health Communications Program), and Kenneth Chui (Public Health and Community Medicine) from the Tufts University School of Medicine in the Department of Public Health and Community Medicine recently published the results from a  formative research study,  Communicating the Experience of Chronic Pain and Illness through Blogging, in the Journal of Medical Internet Research.

The goal of this research was to explore the use of patient illness blogs as a means of communicating the experience of chronic pain  and illness and to articulate the unique set of benefits and barriers of blogging.  Qualitative data from 230 current illness bloggers were collected and analyzed to better understand the self-perceived psychosocial and health effects associated with the blogging activity. Results suggest that blogging about chronic pain and illness may decrease a sense of isolation through the establishment of online connections with others and increases a sense of purpose to help others in similar situations. While the authors’ acknowledge the study limitations, they are hopeful that further research will be conducted to explore the observed associations between communicating the experience of chronic pain through blogging and patients’ coping and self-efficacy when living with chronic pain or illness.

To read the full paper, Ressler, PK; Bradshaw, YS; Gualtieri, L ; Chui, KKH: Communicating the Experience of Chronic Pain and Illness through Blogging,  in the Journal of Medical Internet Research, please click here.

 

1 comment December 11th, 2012

Pain as a Top-Down Phenomenon: a Bibliography

by Daniel B. Carr, MD, FABPM, FFPMANZCA (Hon.), Director, Pain Research, Education and Policy (PREP) Program, Tufts University School of Medicine

Since its inception in 1999, a single concept has unified PREP’s curriculum and connected its community. This theme is that the study of pain is best accomplished if it is seen as a top-down (i.e., population-based) public health phenomenon as noted in the 2011 IOM Report on Pain.  We are fortunate that PREP has always been situated within the Department of Public Health and Community Medicine and grateful that its Chairs and Deans — Harris Berman and Aviva Must — have shared this view and continually encouraged PREP’s growth.

Advances in pain research and education, particularly as informed by the emerging field of social neuroscience, have made PREP’s vision more and more timely.  Reflecting the broader pain community’s growing awareness of PREP’s distinctive voice, this year I’ve had the privilege of delivering keynote addresses at congresses of the American Pain Society, the Special Interest Group on Pain Education of the International Association for the Study of Pain, and the American Society of Pain Educators’ PAINWeek. The specifics of each talk differed somewhat but all conveyed PREP’s underlying theme.

In response to requests from attendees at these lectures, I have assembled an interim bibliography to allow anyone interested to become better informed about some of the sources that the PREP program draws upon. Reflecting PREP’s interprofessional, eclectic outlook, many are from the humanities and social sciences, complemented by the biomedical literature.  For example, according to the narrator in the novel by Greer, “I do not know what joins the parts of an atom, but it seems what binds one human to another is pain”.

Those who wish to immerse themselves in our curriculum will enroll in a course or one of our certificate or degree programs. Click here to find out more about taking a course.  Following the great success this summer of PREP 233 (End of Life and Palliative Care, directed by Pam Ressler) in a blended onsite-online format, our foundational course PREP 230 is the next of our courses to be offered in this format.  This fall, PREP 230 will begin on September 28.  To reflect exciting advances in the field of pain, we have changed this course’s title from “Neuroanatomy, Neurophysiology and Neuropharmacology of Pain” to “Neuroscience of Pain: from Society to Synapse”.  Click here to learn more about this course.  As in earlier years it will be directed by Steve Scrivani, who has consistently earned high praise for his meticulous running of this course. Besides his own lectures, over the years Steve has assembled a core group of dedicated, expert faculty to provide students with an unparalleled learning experience.

Click here to access bibliography.

Add comment September 5th, 2012

New Multidisciplinary Pain Program Announced at NIH

By Pamela Katz Ressler, MS, RN, HN-BC, adjunct faculty, Pain Research, Educationand Policy Program, Tufts University School of Medicine

The National Institutes of Health (NIH) recently announced a new multidisciplinary pain program that will be focused on the role of the brain in perceiving, modifying, and managing pain.  The program, lead by internationally recognized pain researcher and neuroscientist, Catherine Bushnell, PhD,  will be based in the National Center for Complementary and Alternative Medicine (NCCAM), a part of the National Institutes of Health.

“Dr. Bushnell’s work has profoundly changed the ways in which we understand and study this very important problem,” said NCCAM Director Josephine P. Briggs, M.D. “Under her leadership, this program will continue to work toward the development of better ways to safely and more effectively treat chronic pain, and advance research on the intersection and integration of pharmacological and non-pharmacological approaches.”

The NIH announcement of the pain program comes at a critical time in the growing burden of chronic pain in our society.  The Institute of Medicine reports that more than 100 million people suffer from chronic pain conditions and nearly $635 billion is spent annually for treatment and lost productivity.

Research projects for the new program will include investigating  how chronic pain produces changes in the brain that may modify how the brain reacts to pain medications, such as opioids; as well as exploring factors such as emotion, environment and genetics in pain perception.

The Tufts Pain Research, Education and Policy program faculty and students will look forward to future collaboration with this innovative new program.

Read the July NCCAM Clinical Digest on Chronic Pain and Complementary Health Practices

Add comment July 17th, 2012

Are Pain Medication Prescriptions Delaying Workers Return to Work?

by Pamela Katz Ressler, MS, RN, HN-BC, adjunct faculty, Pain Research, Education and Policy Program (PREP), Tufts University School of Medicine, moderator PREP-Aired blog

Workplace insurers spend an estimated $1.4 billion annually on opioid pain medication for injured workers, and this number has continued to rise over the past decade.  A recent article in the New York Times, Painkillers Add Costs and Delays to Workplace Injuries highlights a 2008 study by the California Workers Compensation Institute that found that workers who received high doses of opioids stayed out of work three times longer compared with workers with similar injuries who received lower doses of opioids.  However, one must not look at these data in isolation and out of context of current health care reimbursement practices — is it the dose of opioids or other factors that contributed to their inability to return to work?  A trend over the past decade has been for insurers to reimburse for prescription medication but  to reduce or eliminate reimbursement for other pain therapies such as physical therapy, behavioral therapy and intergrative models of pain management.  Perhaps examining current best practices for pain management, which include pharmaceutical as well as other non-pharmaceutical therapies will result in more positive outcomes for injured workers and cost savings for workplace insurers.

What are your thoughts?

Add comment June 7th, 2012

The PREP Program at Tufts University School of Medicine is GOING THE DISTANCE

The Pain Research, Education & Policy (PREP) program at Tufts University School of Medicine is GOING THE DISTANCE! 

Since 1999 Tufts has had a unique program that trains leaders in pain research, education and policy. Our graduates have included nurses, physicians, dentists, physical therapists, nurse practitioners, physician’s assistants, pharmacists, researchers, holistic health practitioners, occupational therapists, massage therapists, social workers, hospice workers, health policy advocates, and other health care professionals.

Your input is valuable to us as we plan our move from Boston only-based classroom learning to distance/online  learning — please take this brief, 21 item educational needs  survey. It should take 10 minutes or less to complete.

 TAKE SURVEY NOW

SURVEY EXTENDED TO APRIL 30th TO ALLOW A BROADER RANGE OF OPINIONS TO BE ADDED.  COMPLETE THE SURVEY BY APRIL 30, 2012 TO BE ELIGIBLE FOR THE PRIZES BELOW! 

If you wish to be eligible to win

  • The new (March 2012) iPad (1st prize)
  • 1 OF 2 iPOD SHUFFLES (2nd Prize)
  • 1 OF 25 iTUNEs $10 GIFT CARDS (3rd Prize)

Just leave your name and email address as directed at the end of the survey.

1 comment April 19th, 2012

Tufts PREP Hosts WEGO Health Twitter Chat (#HAchat) on March 13

by Pamela Katz Ressler, MS, RN, HN-BC, adjunct faculty Pain Research, Education and Policy Program (PREP) Tufts University School of Medicine, PREP-Aired blog moderator and administrator

The Pain Research, Education and Policy Program (PREP) will be hosting the WEGO Health health activists Twitter Chat on March 13, 3 PM EDT (#HAchat). We are thrilled to be sitting around the virtual table with health professionals, caregivers, health activists and advocates to discuss the important issue of chronic pain. To participate in the chat you will need a Twitter account, then join us at this link: tweetchat.com/room/HAchat#

Here are some interesting (and alarming) statistics about chronic pain (note that these statistics do not include pediatric pain).

From MA Pain Initiative survey (2010)

  • 1 out of 4 adults in Massachusetts suffers from persistent pain, interfering with daily life/work for at least some of the time.
  • Among minorities, 42% reported persistent pain

From Institute of Medicine Report on Chronic Pain (2011)

  • Chronic pain (pain lasting more than 3 months) affects an estimated 116 million American adults—more than the total affected by heart disease, cancer, and diabetes combined.
  • Pain also costs the U.S. up to $635 billion each year in medical treatment and lost productivity.

Pain was previously described as a symptom of another disease and was treated as such.  However this definition has been proven to be very narrow.  The Institute of Medicine now describes pain as a public health issue, affecting the health of the society as well as the individual.  This is a call to action for health activists and advocates to educate themselves to work toward better and more comprehensive pain management.

Here are some helpful websites to learn more about the multiple dimensions of pain:

Resources

Want to learn more about the Pain Research, Education and Policy Program at Tufts University Medical School? Did you know that we are the first and only multidisciplinary pain program in the country? Did you know that we welcome both clinicians and health advocates and activists to our program? Did you know that you can take a course without being a matriculated student?  Contact Wendy Williams (Wendy.Williams@tufts.edu), Associate Director of the Tufts Pain Research, Education and Policy Program to discuss how you can make a difference in the treatment of pain.

2 comments March 13th, 2012

Can Diet Play a Role in Pain Management?

by Pamela Katz Ressler, RN, MS-PREP, HN-BC, adjunct faculty Pain Research, Education and Policy (PREP) program at the Tufts University School of Medicine, and moderator of the PREP-Aired Blog

Can diet be a tool in our pain management arsenal?  According to McGill professor and researcher, Dr. Yoram Shir the answer is yes.  The Pain Research, Education and Policy Program (PREP) was honored to host Dr. Shir on  February 9, 2012 and hear about his fascinating research on the association of pain and diet.  Dr. Shir, director of the Alan Edwards Pain Management Unit at McGill University Health Centre, related that moving his lab from Israel to the United States created an unexpected opportunity to study the effect of different standard diets on pain in animal models (lab rats).  The combination of type of protein as well as type of fat suggested an influence on pain in the animals studied.

Exploring the observation of a correlation between diet and pain, Dr. Shir began testing various combinations of protein and fat.  Interestingly, a diet high in soy protein and omega-3 fatty acids appeared to inhibit pain, while a diet rich in canola oil appeared to increase the pain response.  Small pilot studies with human subjects, those suffering from neuropathic pain, have been promising, but larger studies will be needed to further generalize the findings.

The Pain Research, Education and Policy program thanks Dr. Shir for sharing with us his exciting research in diet and pain.

4 comments February 27th, 2012

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