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allied
academies
Journal of Pharmacology and Therapeutic Research
Volume 1 Issue 1
Clinical Pharmacy 2017
Notes:
Page 22
December 07-09, 2017 | Rome, Italy
7
th
World Congress on
Clinical Pharmacy and Pharmacy Practice
Medication management of chronic pain:
A comparison of 2 care delivery models:
Pharmacist + Physician team compared to a
solely physician model
Marlene Slipp
Central Alberta Pain and Research Institute, Canada
Background:
The prevalence of chronic pain is high
and increasing. Medication management is an important
yet challenging component of chronic pain management.
There is a shortage of physicians who are available and
comfortable providing this service. In Alberta, pharmacists
have been granted an advanced scope of practice. Given
this empowerment, their availability, training and skill set,
pharmacists are well-positioned to play an expanded role
in the medication management of chronic pain sufferers.
Objective:
The objective of this study was to compare
the effectiveness and cost of a physician only versus
a pharmacist-physician team model of medication
management for chronic nonmalignant pain sufferers.
Method:
Demographic and prospectively gathered
outcome data were analyzed of 89 patients who had
received exclusively medication management for chronic
nonmalignant pain at a rural Alberta multidisciplinary
chronic pain management clinic. For 56 of the patients, all
medication management services had been provided by a
physician only. 33 of the patients had received medication
management by a team comprised of a pharmacist
and physician. In the team model, the physician did the
medical assessment, diagnosed the type of pain and
established a treatment plan in consultation with the
patient and pharmacist. The pharmacist then provided
the ongoing follow up including education, dose titration,
side effect management and consulted with the physician
as needed. Change in pain (Numerical Rating Scale)
and disability (Pain Interference Questionnaire) over the
course of treatment were recorded. The treatment duration
and number of visits were used to calculate cost of care.
Cost-effectiveness (treatment cost/improvement) was
calculated. Outcome variables were analyzed using an
Analysis of Variance.
Results:
Patients treated by the physician only model
had suffered with pain longer and perceived themselves
to be significantly more disabled prior to treatment. Both
the physician only and the pharmacist-physician team
model of medication management resulted in significant
and comparable improvements in pain, disability and
patient perception of medication effectiveness. Patients
in the physician only group were seen more frequently
and at a greater cost. The pharmacist-physician team
approach was markedly more cost-effective, and patients
expressed a high level of satisfaction with their medication
management.
Conclusions:
The pharmacist-physician team model of
medication management results in significant reductions of
pain and disability for chronic nonmalignant pain sufferers
at a reduced cost and is well accepted by patients.
Biography
Marlene Slipp graduated from the University of Alberta in 1982 with a Bachelor
of Science in Pharmacy. The following year she completed a residency in
Hospital Pharmacy at Victoria Hospital in London Ontario. Her residency
project won the Upjohn Pharmaceutical award. She has continued her career
in hospital pharmacy at the Red Deer Hospital and the Lacombe Hospital as
well as working at CAPRI (Central Alberta Pain & Research Institute). She was
honored to receive an Alberta Pharmacy “Centennial Award of Distinction” in
2011.
Marlene.Slipp@albertahealthservices.caMarlene Slipp, J Pharmacol Ther Res 2017