Pain is the most common cause of disability and its management is especially challenging due to care barriers caused by social determinants of health and the risk of misuse associated with common treatments such as opioids. To improve access to pain treatment and mitigate opioid risk, Saratoga Hospital Medical Group created a pain team to support their primary care providers.
The interdisciplinary pain team consists of two pain management clinical pharmacists and a substance abuse counselor integrated into the primary care setting. They work directly with providers to improve several parameters revolving around opioid risk mitigation and utilization overall for patients prescribed long-term opioid therapy.
The team manages patients via face-to-face and telehealth consultation to not only improve these parameters but optimize pain regimens and help comprehensively stabilize chronic pain. Parameters improved included updating opioid treatment agreements, screening for alcohol and illicit substance use, obtaining urine drug screens and reducing concomitant opioid and benzodiazepine prescribing. Additionally, the team increases the comfortability and management of chronic pain patients on high-dose, long-term opioids who are stable and transitioning from previous outside providers.
The pain team enabled a 57.3% reduction in average opioid dose across a panel of 226 patients in safe and appropriate ways. Of the 226, 50% are still currently working with the team and 24.8% were successfully discharged due to pain stabilization.
For more information, contact Jeffrey Bettinger, PharmD, pain management clinical pharmacist, at firstname.lastname@example.org or 518.339.8567.