The Preliminary Impact of Pain Management Integration into an HIV Specialty Clinic The Scientific Pages of Anesthesia & Pain Management
Date
04/11/2017Abstract
Objective
A significant number of HIV (human immunodeficiency virus) infected patients suffer from chronic pain where providers often lack access to specialty pain management services. Emerging evidence about risks of chronic opioid use has resulted in closer scrutiny of long-term opioid therapy. While some health systems are beginning to employ blanket restrictions on opioid use, others attempt to preserve individualized care by investigating cost-effective ways to extend pain management services to underserved areas. The purpose of this review was to determine the impact of a Clinical Pharmacy Specialist in pain management, collaborating with a subspecialty HIV practice over a ten month period.
Methods
A retrospective medical chart review was undertaken for all HIV positive veterans receiving opioid prescriptions through the Stratton VA Medical Center (SVAMC) HIV clinic from August 2013 to May 2014.
Results
A total of 86 patient records were reviewed. Twenty (23.3%) patients were on opioids at baseline, and during the course of the study, 13 (65%) patients either had their opioids discontinued (7 patients, 35%) or reduced (6 patients, 30%). Among those whose opioids were reduced, the mean percent reduction in opioids was 32% measured as overall reduction from baseline.
Conclusion
The integration of pharmacy pain management services into a subspecialty HIV clinic had a profound impact on patient care and provider morale. Dedicating the equivalent of one day per week, this collaborative model proved to be cost-effective while improving management in a high risk area and delivering specialty services that could improve outcomes, mitigate risk, and reduce burden to providers.