by Pamela Katz Ressler, MS, RN, HN-BC, Faculty, Pain Research Education and Policy program, Tufts University School of Medicine
Dr. Dan Carr, founder and director of the Tufts Pain Research, Education and Policy program was recently featured in a video posted by PainWeek. Dr. Carr has passionately advocated for interprofessional pain education from the inception of the Tufts PREP program. His keynote address from 2012 PainWeek argues that pain is much more than a biophysical model. Watch Dr. Carr’s 2012 keynote address by clicking here.
Learn more about interprofessional team management of pain by participating in a new course offered by Tufts PREP program this summer (click here). Dan Carr, MD, FADM and Sharon Schwartzberg, EdD, will be co-directors of this relevant and innovative blended learning course. Learn from the leaders in the field of pain, connect and network with other professionals in Boston for one weekend and then return home to learn online. For more information about Tufts’ innovative blended learning courses in the Pain Research, Education and Policy Program, click here.
May 8th, 2013
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.
September 5th, 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 member Pain Research, Education and Policy Program (PREP) Tufts University School of Medicine, PREP-Aired blog moderator and administrator
The Tufts Pain Research, Education and Policy Program congratulates Dr. Harris Berman on his recent appointment to the position of Dean of the Tufts University School of Medicine. Dr. Berman, a visionary leader in providing healthcare to populations, has a keen interest in the intersection of public health and medicine. In a recent interview in Tufts Now, Dr. Berman discussed his belief that public health should be a part of medicine, an integral part of how we care for the health of our population. Dr. Berman’s interest in population health and prevention began as a Peace Corps physician in India and continued into his leadership roles of healthcare organizations and academia.
The Tufts Pain Research Education and Policy Program began in 1999 when Dr. Berman held the position of Chair of Tufts’ Department of Public Health and Family Practice (as it was then known). A fellow visionary regarding pain as a public health concern, he welcomed PREP into that department where it has been happily housed ever since, now under the Dean of Public Health and Professional Degree Programs, Dr. Aviva Must.
As we, in the Pain Research, Education and Policy Program move forward in our efforts to address the immense burden of pain globally, we are pleased to have Dr. Harris Berman at the helm of the Tufts University School of Medicine.
October 13th, 2011
by Daniel B. Carr, MD, FABPM, FFPMANZCA (Hon.), Co-Founder and Director of the Pain Research, Education and Policy Program (PREP) at the Tufts University School of Medicine
Each year, September is “Pain Awareness Month” – a time of intense activity for PREP faculty and the entire pain community It is also when PREP’s academic year begins. One key insight connects diverse Pain Awareness activities and PREP’s own vision and mission: PAIN IS A PUBLIC HEALTH ISSUE, AND PAIN EDUCATION IS A PUBLIC HEALTH IMPERATIVE. Now is a perfect time to step back and place some context around this idea at the heart of not only PREP’s curriculum, but also our entire approach to interprofessional education.
The report issued by the Institute of Medicine earlier this summer – “Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research” (ref 1) — is the latest in a series of white papers on pain by governmental and professional groups dating back well over two decades. These include the first US federal clinical practice guideline (ref 2) on any topic, numerous international guidelines (ref 3), and white papers from authoritative sources such as the Mayday Fund (ref 4), the American Academy of Pain Medicine (ref 5), and even the World Health Organization (ref 6). Together, they present steadily accumulating evidence that acute, chronic and cancer-related pain are widely prevalent and exact a major economic and human burden in developed nations and even more so in resource-poor countries. Other common themes include lost opportunities for early intervention to control or prevent the transition from acute to chronic pain, the negative outcomes of undertreated pain, the importance of optimal pain control for patient-centered care, disparities in pain assessment and treatment experienced by minorities and other under-represented groups such as women or those at the extremes of age, and the need “to adopt a population-level prevention and management strategy” (ref 1) for pain. Related to all these is the growing perspective that pain control is a fundamental human right (ref 7) as articulated by Human Rights Watch (ref 8 ) and recently affirmed in the 2010 Declaration of Montreal by delegates to the International Pain Summit (ref 9).
Since its inception in 1999, the Tufts program on pain research, education and policy has been housed in its Department of Public Health and Community Medicine. Although the pain community has long held a consensus that pain is a biopsychosocial phenomenon, most prestigious journal articles and a majority of research funding have emphasized the “bio” end of that word. Thus, the classical Loeser model of pain originates in subcellular nociceptive machinery, then broadens to encompass the experiences of pain and suffering, followed by pain behavior. The Loeser model is an intrinsically individual one.
- (Fig 1. Loeser Model used with permission of Professor John Loeser)
Our program’s framing of pain employs a sociobiological perspective, in keeping with our having been co-founded by a PhD sociologist, Kathy Lasch. Those individuals better able to detect and remember threats to their survival have better odds of propagating their DNA within the collective gene pool. Indeed, within Darwin’s (and more recently, Dawkins’s) “selfish gene” framework, individuals are mere vessels through which genes propagate themselves (ref 10). Whether or not we agree with this view, it sets the stage for interesting discussion by shifting our reference frame to a distinctly supraindividual model of pain. According to PREP’s social model, the experience of pain is still at the core, but to understand it requires research that goes beyond the individual. In human society, research is lost if not translated into education – particularly one that embraces the intersubjective, social and emotional nature of the pain experience. We at PREP are committed to interprofessional education of pain leaders as the most effective way to effect social change – a commitment that led to our program’s specific acknowledgment in the IOM report in its chapter 4, on education. Among recent PREP graduates and applicants we are beginning to see a few exceptional persons who have chosen to spend their careers as policymakers in the important field of pain. I am delighted to see this, because the continuous translation of the benefits of research and education requires ongoing support through enlightened, population-based health policies.
- Fig 2. PREP model
1: Institute of Medicine Report (2011) http://books.nap.edu/openbook.php?record_id=13172
2: AHCPR clinical practice guideline: acute pain (1992) http://www.ncbi.nlm.nih.gov/books/NBK16501/
3: Carr, DB .”The Development of National Guidelines for Pain Control: Synopsis and Commentary”, European Journal of Pain (2001), 5 (Suppl. A) p. 91-98.
4: “A Call to Revolutionize Chronic Pain Care in America: An Opportunity in Health Care Reform”, Mayday Fund (2009) http://www.maydaypainreport.org/docs/A%20Call%20to%20Revolutionize%20Chronic%20Pain%20Care%20in%20America%2003.04.10.pdf
5: Dubois, MY, Gallagher, RM, Lippe, PM. “Pain Medicine Position Paper”, Pain Medicine, vol. 10, issue 6, p. 972-1000, Sept 2009. http://onlinelibrary.wiley.com/doi/10.1111/j.1526-4637.2009.00696.x/full
6: World Health Organization press release (Oct 11, 2004) http://www.who.int/mediacentre/news/releases/2004/pr70/en/index.html
7: Brennan, F, Carr, DB, Cousins, M. “Pain Management: A Fundamental Human Right”, Anesthesia & Analgesia, vol. 105, no. 1, p. 205-221, July 2007. http://www.anesthesia-analgesia.org/content/105/1/205.full.pdf+html
8: Human Rights Watch 2009 report http://www.hrw.org/reports/2009/03/02/please-do-not-make-us-suffer-any-more-0
9: Declaration of Montreal 2010 from International Pain Summit http://www.iasp-pain.org/Content/NavigationMenu/Advocacy/DeclarationofMontr233al/default.htm
10: Carr, DB; “What Does Pain Hurt?”, IASP — Pain Clinical Updates, vol. XVIII, issue 3, p. 1-6, July 2009 http://www.iasp-pain.org/AM/AMTemplate.cfm?Section=HOME&TEMPLATE=/CM/ContentDisplay.cfm&SECTION=HOME&CONTENTID=9599
September 1st, 2011
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP candidate, PREP-AIRED blog moderator and administrator, Tufts University School of Medicine
Please join the Pain Research Education and Policy Program’s (PREP) faculty, students and alumni for the 2011 Sackler Lecture on Thursday, April 21 at 4 PM in the Tufts Medical Center’s Wolff Auditorium. The PREP program is honored to host Dr. Rollin (Mac) Gallagher, MD, MPH for this year’s lecture. Dr. Gallagher, a prominent expert in the field of pain management, will address the complex pain issues confronting the military in today’s wars and how the VA Health System is managing these from acute injury through rehabilitation. His lecture is entitled: “The Veterans Administration Department of Defense Systems Redesign: Pain Management for Wounded Warriors from Injury to Recovery”.
Dr. Gallagher currently serves as Director of Pain Management, Philadelphia Veteran Affairs Medical Center. He is also Clinical Professor of Psychiatry, Anesthesiology and Critical Care and Director for Pain Policy Research and Primary Care, Penn Pain Medicine Center, University of Pennsylvania School of Medicine. He is Editor-in-Chief of Pain Medicine, the official journal of the American Academy of Pain Medicine, that he has also served as president. He currently serves on the National Pain Management Strategy Coordinating Committee for the Department of Veterans Affairs.
If you cannot join us in person for Dr. Gallagher’s lecture, we will have a link to his recorded lecture posted here next week.
April 19th, 2011
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP candidate, PREP-AIRED moderator and administrator, Tufts University School of Medicine
The Pain Research, Education and Policy Program(PREP) is the first and only multidisciplinary university-based pain curriculum program in the nation. There are numerous reasons to become part of the PREP program: small class sizes, diverse student backgrounds, and expert faculty are a few of the unique qualities of the program. What also sets the PREP program apart is the continued connection with PREP alumni, who are are welcomed and encouraged to remain an integral part of the PREP program.
Here are 4 top reasons for PREP Alumni to return to Tufts:
#4 Meet world renowned speakers and authors:
Please join us to hear two prominent pain experts lecturing in April. Melanie Thernstrom will be speaking about her acclaimed book, The Pain Chronicles on April 12, 2011 at 4pm in the Wolff Auditorium at Tufts Medical Center.
Dr. Rollin (Mac) Gallagher of the University of Pennsylvania and the VA Administration will describe recent efforts to alleviate pain and suffering beginning in the battlefield and extending through rehabilitation. He will be speaking in the Wolff Auditorium at Tufts Medical Center at 4pm. The date of his lecture is April 21, 2011.
#3 Network with New Alumni
Come and hear our graduating MS student capstone presentations on Monday, May 2 from 3:30pm to 5:00pm in Conference Room 1, M&V Building. We would love your support and networking with our hard-working graduates.
#2 Enroll in a Tufts course and save 75%
Did you know that all alumni from the Public Health and Professional Degree programs are able to enroll in a maximum of three courses in PHPD (one per year) at a 75% savings??? Yes, you can take that elective that you always wanted to and spend only 25% on that course! Contact Lauren Budd, Assistant Registrar at firstname.lastname@example.org for more information.
#1 Expand your world by connecting with PREP’s social media sites
In addition to PREP-AIRED, the PREP program’s widely read blog, the PREP program now has its own Facebook page. Join the community of current students, policy makers, leaders in the pain conversation and alumni by “liking” our page. Here is the link: http://www.facebook.com/#!/pages/PREP-Pain-Research-Education-and-Policy-Graduate-Program-Tufts/198047410219415
What are your top reasons for returning to Tufts?
April 6th, 2011
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator and administrator
Anticipate, Assess, Alleviate
The International Association for the Study of Pain (IASP) is the leading professional forum for science, practice and education in the study of pain. Each year the IASP focuses on an area of importance in the field of pain management. This year’s focus is acute pain, with 2010-2011 being designated as the Global Year Against Acute Pain by the IASP. Acute pain is the most frequent reason why patients visit an emergency department. Unfortunately, inadequate acute pain control is common. If uncontrolled or inadequately controlled, acute pain can result in increased health care costs due to longer hospital stays and a higher liklihood of the development of chronic pain. By raising awareness of acute pain as a significant health care issue, the IASP hopes to lessen the gap between acute pain knowledge and research and current clinical practice.
Click here to access resources and information about acute pain mangement and how to become involved in the IASP Global Year Against Acute Pain.
January 30th, 2011
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED Blog Administrator and Moderator
As we enter a new year, pain is still the #1 reason individuals seek out medical care (American Pain Foundation data). Those who are involved in research, as well as direct caregivers of patients, know that pain is complex and needs to be addressed by a multi-modal and interdisciplinary approach. Let’s take stock of where we are and where we hope to go in 2011. We invite you to comment, discuss and brainstorm ways that we can more effectively manage pain on this site Let’s envision a day when pain is no longer the #1 reason individuals seek medical care.
Happy New Year…may your year be filled with opportunities and possbilities.
January 3rd, 2011
by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP graduate student and PREP-AIRED blog moderator
Untreated or under-treated pain causes needless suffering and negatively affects the quality of life. That is why the management of pain remains a critical area of health care and why the concept is addressed throughout the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirements.
We congratulate the Tufts University School of Medicine’s Pain Research, Education and Policy Programs co-founder, Daniel Carr, MD, FABPM for providing the forward to the newly published second edition of Approaches to Pain Management: An Essential Guide for Clinical Leaders
Approaches to Pain Management: An Essential Guide for Clinical Leaders, published by the Joint Commission Resources, provides an overview of pain assessment and management, identifies what the standards require regarding the treatment of patients with pain, and offers guidance on making pain management an integral part of care services. Dr. Carr, an internationally recognized expert in pain management, provides both perspective and vision on the complex nature of pain.
The majority of the book is devoted to the best practices of health care institutions that have adopted focused pain programs. This updated guide also incorporates a global view of pain management, additional organizational best practices—including some from non-U.S. institutions. Other features include the following:
- Summaries of every Joint Commission and Joint Commission International pain assessment and management requirement across all health care settings
- Strategies for identifying and using evidence-based medicine resources for pain management
- Expanded case study chapters from clinical leaders describing how their organizations developed and implemented their pain management activities
- Techniques and ideas for understanding and meeting pain-related standards
- Guidance on committing an organization to pain management improvements
For more information about the newly released edition of Approaches to Pain Management: An Essential Guide for Clinical Leaders, click here
November 29th, 2010