by Pamela Katz Ressler, MS, RN, HNB-BC, Faculty, Pain Research, Education and Policy Program, Tufts University School of Medicine, moderator of PREP-Aired Blog
The PREP program congratulates faculty member Carol Curtiss, MSN, RN-BC on the publication of her article, I’m Worried About People in Pain, in the American Journal of Nursing ( AJN, Jan 2016, Vol 116, No. 1). Carol skillfully argues that while both chronic pain and prescription drug abuse are public health crises in the U.S., efforts to address opioid abuse may lead to unintended consequences for people who suffer with persistent pain and benefit from responsible use of opioids as part of a comprehensive treatment plan. As we tackle the complex public health crisis of prescription abuse through regulation and policy, we must also remain cognizant of the needs of those who suffer from chronic pain by including pain clinicians and patients at the health policy table.
March 22nd, 2016
by Pamela Katz Ressler, MS, RN, HN-BC, adjunct faculty, Pain Research, Education and Policy (PREP), Tufts University School of Medicine
The Pain Research, Education and Policy Program (PREP) is honored to present the Annual Sackler Lecture with guest speaker, Scott M. Fishman, MD, chief, Division of Pain Medicine and Professor of Anesthesiology and Pain Medicine (School of Medicine, University of California-Davis), on Thursday, January 31, 4:00-5:00 PM in the Wolff Auditorium at Tufts Medical Center (800 Washington St, Boston).
Dr. Fishman, a world-renowned authority on pain management, will lecture on the subject of interprofessional and competency-based education for clinicians managing pain. Chronic, or persistent pain, is not only a personal health issue, but a public health and economic challenge for our country. It is estimated that chronic pain costs the United States economy over $635 billion annually due to medical care and lost productivity. Yet, we are not adequately addressing this societal burden. As pain management has evolved over the past decades, it has become apparent that a multi-modal and interprofessional approach to pain is necessary. However, interprofessional pain management is often underutilized for many factors, one being a paucity of interdisciplinary educational opportunities for clinicians. Training our health care professionals to manage pain in an interprofessional model will allow for our health care system to effectively care for the increasing numbers of individuals suffering from chronic or persistent pain. The need for increased interprofessional training in pain management was recently highlighted in the Institute of Medicine’s 2011 report: Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. In addition to his clinical work at UC-Davis, Dr. Fishman serves as a co-principal investigator of the Interprofessional Pain Management Competencies Working Group of the Mayday Fund.
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 Dr. Fishman’s informative and engaging lecture, immediately followed by an interprofessional panel discussion.
For more information about the event, click here
January 21st, 2013
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 innovative 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.
January 15th, 2013
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.
December 11th, 2012
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
July 17th, 2012
by Pamela Katz Ressler, MS-PREP, RN, HN-BC, adjunct faculty Pain Research, Education and Policy Program, Tufts University School of Medicine and PREP-Aired blog moderator
As has been discussed previously in this blog, the under-treatment of chronic or persistent pain places an enormous burden on individuals, the health care system, the economy and our society. In June 2011, the Institute of Medicine reported that there are an estimated 116 million individuals in the United states who report chronic pain, at an economic cost of $635 billion per year. According to a recent article by Matthew Brady in the magazine of the site, Angie’s List, (which reviews numerous categories of service and health care providers;) “health care providers in the pain management category garner negative reviews at twice the average of other Angie’s List categories” Additionally, Angie’s List members reported that their “health care provider didn’t take their problem with pain seriously”.
While reports of patient dissatisfaction with chronic pain management are disturbing, they are understandable when one recognizes the paucity of training most clinicians receive in chronic pain management. According to the Association of American Medical Colleges less than 1 in 4 of the 133 accredited medical schools in the country teach students about chronic pain management and most students receive less than 11 hours of pain management training in their entire 4 years of medical school.
Addressing the systemic lack of comprehensive pain education is a key mission of the Tufts University School of Medicine’s Pain Research, Education and Policy Program (PREP). The founding director of the PREP program, Dr. Dan Carr, states that the high level of dissatisfaction and complaints among patients seeking effective chronic pain management may reflect the traditional training of clinicians to focus only on objective measures and procedures to alleviate pain, without regard to the social and psychological aspects of persistent pain. “There is an enormous social component to pain,” states Dr. Carr. “Patients will be more satisfied if they feel they have been cared for. That has more to do with their satisfaction with pain control than the actual intensity of their pain.”
While there are no easy answers to chronic pain management; patients, clinicians, educators and health care stakeholders all agree that our current approach to pain management is inadequate and needs to be addressed as we prepare to meet the increasing health needs of an aging baby-boomer population.
What are your thoughts on how we can create a more comprehensive model of chronic pain management?
December 8th, 2011
by Wendy Williams, BSN, M.Ed., Associate Director of the Pain Research, Education and Policy Program (PREP), Tufts University School of Medicine
The evidence continues to mount that proactive pain management makes a difference in lives (in this case, for both the identified patient and the staff and families that care for them in nursing homes).
A research article was published in the British Medical Journal on July 17th and concludes the following: “A systematic approach to the management of pain significantly reduced agitation in residents of nursing homes with moderate to severe dementia. Effective management of pain can play an important part in the treatment of agitation and could reduce the number of unnecessary prescriptions for psychotropic drugs in this population.”
You can listen to a BBC journalist interviewing one of the authors here. This problem has been outlined before; the challenge of good pain assessment in the non-verbal. In particular, a 2006 Web-MD article reviews a study done in Australia by Leonie J. Cole and colleagues entitled – Pain a Problem in Alzheimer’s Disease: Undertreated Pain Plagues Alzheimer’s Patients Who Hurt, but Can’t Tell.
Have you heard of any good studies recently? We need to keep promoting evidence based practice and advocacy for people with undertreated pain…. Hope to hear from you on any news you might have on this front.
July 18th, 2011
by Pamela Katz Ressler, MS-PREP, RN, HN-BC, PREP-Aired blog moderator and administrator, Program in Pain Research, Education and Policy (PREP) at Tufts University School of Medicine
As we mentioned in our last blog post, The International Association of the Study of Pain , along with other prominent pain organizations such as The Mayday Fund, the Institute for Palliative Medicine at San Diego Hospice, the Union for International Cancer Control, have joined with the Lien Foundation by co-sponsoring a series of 50 short documentary films spotlighting the global burden of inadequate pain treatment in the project: LIFE Before Death.
This week’s short film is entitled: Quality of Life and focuses on the dramatic benefits of palliative care services offered to patients and families facing end of life issues.
We welcome your comments on the overall LIFE Before Death project or the specific short films, which we will continually highlight on the Tufts University Pain Research, Education and Policy Program’s PREP-Aired blog throughout the year.
June 17th, 2011
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP candidate, PREP-AIRED moderator and administrator, Tufts University School of Medicine
When Bat Masterson, RN, a former Navy nurse, was hired as the emergency department case manager at Kootenai Medical Center, a 246 bed acute care hospital in Coeur d’Alene, Idaho, he recognized that an effective, collaborative, multidisciplinary pain management plan was needed. He saw that repetitive emergency department visits for pain issues were often the norm for patients without primary care health care providers and there was limited follow-up for effective pain management for these patients. Additionally, staff were often burdened by responding to drug-seeking or doctor-shopping individuals who visited the emergency department repeatedly to attempt to obtain narcotic prescriptions. In 2006, Mr. Masterson and a multidisciplinary team of health care professionals developed the Pain Care Management Program that embraced a coordinated care model and electronic communication tools to monitor and support pain patients who visited the emergency department. Four goals of emergency department pain care were identified by the team and served as guiding principles in the development of strategies and interventions of the Pain Care Management Program of Kootenai Medical Center.
- Manage patients with chronic pain or pain related complaints through coordination of care with the patient’s primary physician and the Emergency Department.
- Support the treatment goals of the primary physician without encumbering the Emergency Department.
- Use non-narcotic pain relief, whenever possible, and as a standard of care for the treatment of headaches.
- Provide the best care for the patient for the condition they have that day
The results of the Pain Care Management Program have been impressive:
- A 77% reduction in emergency department visits for pain care management.
- An increase from 42% to 89% of individuals in the pain care study with primary care providers
- Improved patient and nursing satisfaction scores
Congratulations to Bat Masterson, RN and the emergency department pain care management team at Kootenai Medical Center for an innovative and collaborative model of pain care.
Click here to read a PainEDU.org interview with Mr. Masterson
May 16th, 2011
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP candidate, PREP-AIRED moderator and administrator, Tufts University School of Medicine
One in 10 people in the United States identifies themselves as having chronic pain. Over $90 billion is spent annually in the United States on the associated costs of chronic pain, including disability, medical costs, and loss in productivity. The global impact of chronic pain is immense. Yet treatment of chronic pain remains as elusive to our modern medical treatment methods as it did to the ancient Greeks. In The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing and the Science of Suffering, author Melanie Thernstrom masterfully weaves her personal pain narrative into a rich tapestry of the science, history, culture and ethical underpinnings of the study of pain. The PREP program’s director, Dr. Daniel Carr, lends a pivotal voice in Ms. Ternstrom’s understanding of the challenges of pain medicine, along with other pain medicine luminaries such as Dr. Scott Fishman and Dr. Clifford Woolf. What makes The Pain Chronicles so compelling are the multiple layers of inquiry that unfold throughout the book, often challenging the reader to ask more questions than find answers on the nature of pain and suffering. Ms. Thernstrom’s use of the patient voice from the perspectives of authors such as Elaine Scarry (The Body in Pain) and Arthur Frank (At the Will of the Body) help to illustrate the complex interaction between pain perception and suffering. The Pain Chronicles allows a deeper understanding of the disease of pain, and should be “required reading” for both patients and health practitioners for whom chronic pain plays a role in their lives.
The Tufts Pain Education and Policy Program, with assistance from the Tufts University Public Health and Professional Degree Student Activity Fund, is pleased to be hosting author Melanie Thernstrom on Tuesday, April 12 at 4:00 PM in the Wolff Auditorium at Tufts Medical Center. The event is free and open to the public. Signed copies of The Pain Chronicles will be available. Please join us!
Here is a link to Melanie Thernstrom’s lecture on April 12: http://www.tufts.edu/med/education/phpd/msprep/prepforum.html
April 11th, 2011