 |
 |
 |
 |
 |
 |
|
APS
E-News Important Dates 2007
Conference: NAPF
Forums: In This Issue APS Supports IASP Global Awareness Initiative on Pain in Older Adults News Highlights from The Journal of Pain Important
Information for Healthcare Providers Who Treat Patients with Pain APS Call for 2007 Paper and Poster Abstracts Update on Palliative Care Education and Training Act APS E-News Then and Now: Survey Results
|
| Acknowledgment:
|
| American
Pain Society |
| September is Pain Awareness Month. This month you will receive two issues of E-news.
APS Supports IASP Global Awareness Initiative on Pain in Older Adults Among the pain management and research communities, it's well known that within the nation's growing population of older people, an estimated 50% live with persistent pain. Widespread misperceptions continue to influence attitudes of healthcare providers and their aging patients. For example, it's still common for providers, patients, and families to believe pain should be accepted as an inevitable consequence of aging. That's why this year the International Association for the Study of Pain (IASP) and APS are collaborating on global public and professional awareness initiatives to improve understanding about what can and should be done to treat chronic pain in older adults. September is Pain Awareness Month, and APS is involved in programs with IASP and Partners for Understanding Pain to promote improved pain care for older adults. "The prevalence of persistent pain climbs steadily with advancing age. Studies show that by the seventh decade of life the rate of persistent pain exceeds 50% in community-based samples and a whopping 80% are in residential aged care," said Keela Herr, PhD RN, professor and chair, adult and gerontological nursing, University of Iowa. "A major problem is that older people think they have to live with pain and also are worried about becoming addicted to pain medication. This makes pain assessments in the elderly a difficult challenge because older patients tend to under-report their pain," she added.
Herr added that despite the high prevalence of persistent pain in older adults, the overwhelming majority of pain studies continue to be conducted in younger populations. "There is a glaring lack of scientific data on pain management in older adults. As a result, multidisciplinary pain programs that can be successful in many older patients are underutilized because this group is under represented in pain studies and clinics and receives fewer treatment options," she explained. APS, according to Herr, can be a highly effective advocate for improved pain care in older adults. "We know pharmacological therapy for persistent pain is most effective when combined with other approaches, such as cognitive behavioral therapies, physical therapy, and exercise regimens. However, older persons are more vulnerable since they suffer from concurrent medical problems that can limit treatment options with analgesics. So when formulating pain treatment plans for older patients, clinicians must be aware of the risks posed by concurrent medications and comorbid medical and psychosocial problems," Herr explained. To achieve meaningful progress in combating pain in older adults, Herr believes pain clinicians need more professional education programs focused on treating this growing population. "There is an urgent need for better professional education programs, further dedicated research to help guide clinical practice, and better pain management strategies to address the special needs of older patients with persistent pain. On September 12, Dr. Herr represented APS during a national radio news release to kick off the year-long effort with IASP and Partners for Understanding Pain to improve professional and public awareness about pain in the elderly. Please click here to listen to Dr. Herr's radio appearance.
News Highlights from The Journal of Pain
Peripheral
and Central Contributions to Hyperalgesia in Irritable Bowel Syndrome Irritable bowel syndrome (IBS) is a common gastrointestinal disorder in which patients experience chronic abdominal pain associated with alterations in bowel patterns. The majority of IBS patients have low thresholds for visceral pain, increased intensity of sensations, and widespread hyperalgesia. In this study, University of Florida researchers examined recent evidence for potential neural mechanisms that may contribute to somatic and visceral hyperalgesia in IBS patients. The authors reported their evaluations of human and rat studies for this research clearly point to a spinal mechanism consistent with observations that IBS patients have enhanced responses to visceral and cutaneous stimuli throughout the pain matrix of the brain. However, they concluded it is unclear whether enhanced responses result from a facilitating mechanism in the brain, a spinal sensitization due to input from the rectum and/or colon, or a mechanism from the brain to the spinal cord or gut. The study concluded that primary visceral and secondary cutaneous hyperalgesia in IBS patients involve a mechanism dynamically maintained by tonic input from abnormal receptors in the colon and /or rectum. Further secondary hyperalgesia is likely to be at least partly related to sensitization of spinal cord neurons and, therefore, might be similar to other persistent pain conditions, such as fibromyalgia and complex regional pain syndrome. Commentary
by Emeran A. Mayer, VA Medical Center West Los Angeles Commentary
by Mickael Bouin, University of Montreal
Breakthrough pain is the transitory exacerbation of pain that occurs in otherwise controlled pain patients. It is estimated that up to 90 percent of cancer patients with chronic pain experience breakthrough pain. However, little is known about the prevalence and characteristics of breakthrough pain in populations with chronic noncancer pain treated with opioid medications. Researchers from nine different pain centers recruited 228 patients and administered a phone questionnaire. All patients had controlled baseline pain, and 74 percent said they experienced severe breakthrough pain. The most common syndrome was low-back pain. The authors concluded that breakthrough pain is highly prevalent and variable in patients treated with opioids for noncancer chronic pain. They further noted that if future studies show adverse outcomes of breakthrough pain similar to cancer patients, clinicians will need to assess and manage this pain in noncancer patients as well.
It is widely believed that gender socialization influences pain responding. Males typically are expected to withstand pain as evidence of being masculine and females accept pain as a normal part of life and are viewed as more willing to report pain. No published studies have examined the role of gender socialization in pain responses exhibited by children and adolescents. The goals of this study, therefore, were to examine the relationship of sex, gender socialization and age to responses to laboratory pain stimuli in healthy children and adolescents. Two-hundred-forty healthy subjects, equally divided by gender, participated in the study. The authors reported there were no significant mean differences between girls' and boys' responses to laboratory pain. There was a trend for girls to exhibit lower tolerance for pressure pain, however. They concluded that the findings lend preliminary support to the view that gender socialization contributes to variability in responses to laboratory pain. This finding, however, does not appear to be stable across age, types of pain stimuli, or parameters of pain response.
Important Information for Healthcare Providers Who Treat Patients with Pain
Upcoming Forum Dates and Locations: The North American Pain Forum (NAPF) 2006, in collaboration with APS and The Foundation for Better Health Care (FBHC), is launching an innovative, comprehensive program dedicated to providing timely, practical information to primary care physicians, nurse practitioners, physician assistants, and nurses with a focus on increasing the clinical understanding of pain. The goal of the program, which is cochaired by Bill McCarberg, MD, and Dennis Turk, PhD, is to offer new strategies for the clinical assessment, treatment, and successful management of patients with acute and chronic pain, including end-of-life pain. The NAPF 2006 forums have a unique format. They offer attendees the opportunity to learn from eight plenary sessions and participate in eight interactive workshops during the 2-day program. The forums provide 15 hours of CME content to meet the AB487 Requirement for Califorinia-Licensed Physicians. In addition to the comprehensive educational forums that provide evidence-based findings on the latest advances in assessing and managing patients with pain, other CME components of the NAPF '06 program include:
Visit NAPF online at www.napainforum.org to register.
NIH Funding Announcement: Mechanisms, Models, Measurement, & Management in Pain Research (R01,R21,R03) This funding opportunity, issued by the National Institute of Nursing Research (NINR), seeks to inform the scientific community of the pain research interests of the various Institutes and Centers (ICs) at the National Institutes of Health (NIH) and to stimulate and foster a wide range of basic, clinical, and translational studies on pain as they relate to the missions of these ICs. Synergistic studies that reach across two or more of these areas are welcomed. Interdisciplinary and multidisciplinary research is especially encouraged. These pain research areas also cut across ICs and programs and should not be viewed as restricted to only one specific IC. ICs include
New advances are needed in every area of pain research, from the micro perspective of molecular sciences to the macro perspective of behavioral and social sciences. Although great strides have been made in some areas, such as the identification of neural pathways of pain, the experience of pain and the challenge of treatment have remained uniquely individual and unsolved. Research to address these issues conducted by interdisciplinary and multidisciplinary research teams is strongly encouraged, as is research from underrepresented, minority, disabled, or women investigators. For more information, visit grants1.nih.gov/grants/guide/pa-files/PA-06-544.html.
New
APS SIG: Pharmacotherapy
Call for Election Nominations: Coming Soon! Are you ready to pursue a national leadership position in APS? Do you demonstrate such leadership qualities as vision, strategic thinking, motivation, and a sense of dedication to the society and its mission? If you answered yes to any or all of these questions, or if this sounds like someone you know, the APS Nominating Committee requests your election nomination. Open positions include President-Elect, Treasurer and three Directors-at-Large, and seven positions on the Nominating Committee. Nominees must be active APS Regular Members, and most importantly, want to achieve positive outcomes for the society, its members, and those who are served by its efforts. These positions will be elected this winter to take office at the 2007 annual meeting. Members will receive an invitation to nominate potential election candidates in October. Those with active e-mail addresses will be notified by e-mail. Those without e-mail will receive instructions by mail. In addition, position descriptions, a list of current board and nomination committee members and vacancies, and the disciplinary composition and geographic representation of the board is available on the APS Web site. APS has worked hard to make the nomination and voting process easy for you; your participation will make it meaningful. Please take advantage of this opportunity. Your participation is important.
APS Call for 2007 Paper and Poster Abstracts Click here to visit the call online. Submissions are due October 27, 2006.
Update on Palliative Care Education and Training Act After being unanimously passed by the New York State Legislature, the Palliative Care Education and Training Act [AB11162, S07458A] to improve palliative care and pain management was vetoed by Governor Pataki. To read more about Compassion and Choices, the group that championed this legislation, visit www.compassionandchoices.org.
APS E-News Then and Now: Survey Results APS E-News debuted in January 2003. Earlier this year, we ran nearly the same reader satisfaction survey that was featured in our November 2003 reader survey to compare feedback. Thank you to all who shared their valued feedback with us. The questions and responses (2003 responses are in black and the 2006 responses are in red) are below. On
a scale of 1 to 5, with 1 being "least important" and 5 being "most
important," here's how you rated the following topics that frequently
appear in APS E-News (average scores): Have
you ever forwarded an APS E-News issue to a colleague? APS
E-News is transmitted monthly. This frequency is: What
other topics would you like to see featured in APS E-News? Funding
announcements In this year's survey we also asked those who are interested to provide their names as a way to express interest in being involved with APS. Those names have been shared with the APS leadership and you will be contacted as opportunities become available. APS E-News welcomes your comments at any time. Please send your thoughts to dpinkston@connect2amc.com.
In the August e-news announcement of the 2006–2007 The Mayday Fund Fellows, the acknowledgement of the fellows who are also APS members incorrectly did not include Steven J. Weisman, MD, who is a long-time APS member. We regret the omission. |
Herr
said pain assessments for the older population require a multifaceted,
comprehensive approach. "In older patients, we must be more comprehensive
in assessing pain, especially for those who have impaired hearing
or vision, dementia or other types of cognitive impairment," said
Herr. "These patients have difficulty communicating their pain and
usually receive fewer analgesics than others of the same age."
The
following highlights summarize selected articles from the August
2006 issue (volume 7, number 8).