Pain SHP

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Jointly sponsored by
University of Kentucky
College of Pharmacy
and Vemco MedEd

This activity is supported
by an educational grant from
Janssen Pharmaceuticals, Inc.,
administered by
Janssen Scientific Affairs, LLC

The online tutorial series with a case reinforces practical application of tools and competencies acquired during the live activity. Each tool is a combination of essentials in clinical practice, links to relevant scientific publications, and printable handout material for reference. Clinical Case following the online tutorials gives the learners an opportunity to earn extra CE credit upon completion.

Assessment of Pain

Comprehensive assessment of pain is an essential part of any pain management plan. Comprehensive assessment involves several components, including:

Detailed patient history
Physical examination
Pain characterization (location, intensity, duration, frequency, onset)
Complete risk assessment
Clarifying the pathophysiology of the pain

The Institute for Clinical Systems Improvement offers an assessment algorithm that includes:

Step 1: Pain Assessment

Patient history and physical
Ask key questions about the pain
Utilize pain and functional assessment tools

Step 2. Determine the Biological Mechanisms of Pain

Neuropathic pain
Nociceptive Pain

Muscle pain
Inflammatory pain
Mechanical/compressive pain

Step 3. Other Patient Assessments (if the pain is chronic and there are no correctable causes of pain)

Work and disability issues
Psychological and spiritual assessment
Contributing factors and barriers

Step 4. Develop a Pain Management Plan

An important goal of the initial assessment of pain includes establishing rapport with the patient that can help to engage the patient, foster appropriate treatment expectations, and promote a coordinated approach to management.

Citation

Institute for Clinical Systems Improvement (ICSI). Health Care Guideline: Assessment and Management of Chronic Pain. Fourth Edition. November 2009. Available at www.icsi.org.

Suggested Reading:

JCAHO. Pain: Current Understanding of Assessment, Management, and Treatments. December 2001. Available at: http://www.npcnow.org/App_Themes/Public/pdf/Issues/pub_related_research/pub_quality_care/Pain-Current-Understanding-of-Assessment-Management-and-Treatments.pdf.
Voepel-Lewis T, et al. Reliability and validity of the face, legs, activity, cry, consolability behavioral tool in assessing acute pain in critically ill patients. Am J Crit Care. 2010;19:55-61. Article available at: ajcc.aacnjournals.org/content/19/1/55.long.
Herr K. Pain assessment strategies in older patients. J Pain. 2011;12(3 Suppl 1):S3-S13. Abstract available at: www.ncbi.nlm.nih.gov/pubmed/21396599.