Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Australia; UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK.
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Australia; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC, 3052, Australia.
Res Social Adm Pharm. 2019 Feb;15(2):207-213. doi: 10.1016/j.sapharm.2018.03.060. Epub 2018 Mar 19.
Inappropriate use of pain medication has serious consequences for older populations. Experts in the field have noted an increase in opioid prescriptions, and opioid-related hospitalisations and deaths among this vulnerable population. In the pursuit of educating pharmacists, physicians, allied healthcare professionals, researchers, academics and the public facing the challenges of chronic pain medication management, 'The Inaugural Monash University School of Public Health and Preventive Medicine (SPHPM) Best Practice in Chronic Pain Medication Management Day Conference' was held in December 2016 at the Alfred Medical Research and Education Precinct (Melbourne, Australia).
Fifteen experts presented on aspects of chronic pain epidemiology and current analgesic use in older Australians, and discussed current practice and associated challenges.
Presenters highlighted the dramatic increase in opioid prescribing, development of tolerance and withdrawal symptoms, problems with abuse and addiction, increased risk of death from overdose or suicide, potentiation of sedative effects with concurrent use of anxiolytics/hypnotics, and medication diversion.
Pharmacists are very accessible to patients and are crucial members of medication management teams. They have the necessary medication expertise to review medication regimens and provide patient education. Towards addressing chronic pain medication management of older populations, pharmacists can contribute in several ways, such as being aware of relevant guidelines and completing further training, contributing to policy and guideline development, participating in multidisciplinary panels, working groups and pain management teams, collaborating on research projects, and educating the community. With regards to opioid medication management, pharmacists are in an ideal position to: monitor prescription dispensing and potential misuse, provide education about overuse, and, if appropriate, provide access to naloxone. In order to fulfil these roles and responsibilities, allied healthcare professionals should be educated and informed, and opportunities for continuing professional education should be available and utilised. Pharmacists should have the necessary knowledge and skills to optimise chronic pain management, and to both deliver and inform policies and guidelines on pharmacological management of chronic pain in older people.
老年人在使用止痛药方面的不当会产生严重后果。该领域的专家注意到阿片类药物处方的增加，以及在这一弱势群体中与阿片类药物相关的住院和死亡事件的增加。为了教育药剂师、医生、医疗保健专业人员、研究人员、学者和公众面对慢性疼痛药物管理的挑战，“莫纳什大学公共卫生与预防医学学院（SPHPM）首届最佳慢性疼痛药物管理日会议”于 2016 年 12 月在澳大利亚墨尔本的阿尔弗雷德医学研究与教育区举行。
15 位专家介绍了慢性疼痛流行病学和澳大利亚老年人当前镇痛药物使用的各个方面，并讨论了当前的实践和相关挑战。
演讲者强调了阿片类药物处方的急剧增加、耐受性和戒断症状的发展、滥用和成瘾问题、因过量或自杀导致的死亡风险增加、与镇静剂/催眠剂同时使用时增强镇静作用，以及药物转移。
药剂师与患者非常接近，是药物管理团队的重要成员。他们具有审查药物治疗方案和提供患者教育的必要药物专业知识。为了满足老年人群体的慢性疼痛药物管理需求，药剂师可以通过多种方式做出贡献，例如了解相关指南并完成进一步培训、为政策和指南制定做出贡献、参与多学科小组、工作组和疼痛管理团队、合作开展研究项目以及向社区提供教育。关于阿片类药物管理，药剂师处于理想的位置，可以：监测处方配药和潜在滥用情况，提供关于过度使用的教育，以及在适当情况下提供纳洛酮。为了履行这些角色和责任，医疗保健专业人员应接受教育和通知，并且应提供和利用继续教育机会。药剂师应具备优化慢性疼痛管理的必要知识和技能，并为老年人慢性疼痛的药理学管理制定和告知政策和指南。
