Bettinger Jeffrey, Cleary Jacqueline, Fudin Jeffrey
Saratoga Hospital Medical Group, Saratoga, NY, USA.
Albany College of Pharmacy and Health Sciences, Albany, NY, USA.
Med Access Point Care. 2020 Aug 15;4:2399202620947035. doi: 10.1177/2399202620947035. eCollection 2020 Jan-Dec.
Patients with chronic pain syndromes are facing additional challenges from syndrome coronavirus 2 (SARS-CoV-2) virus compared with the general population. New reasons for compounded social isolation and commensurate opioid dose creeping and suicidality/anxiety, difficulty in obtaining legitimate medications, proper comprehensive evaluations, ongoing opioid risk stratification for opioid abuse/misuse, safe opioid tapers if necessary, and other opportunities for pharmacist intervention are clear. We discuss opportunities for pharmacist-run telehealth visits, reimbursement for services, and various aspects of interventions during this time of international emergency where all healthcare professionals have been asked to step up to help combat the mutual threat of COVID19. Clinical pharmacists in every specialty area are part of the essential healthcare workforce, but those practicing pain management in particular are in unique positions to assist all providers in adhering to chronic pain guidelines and various government mandates, and to foster optimal outcomes to complex patients with chronic pain. Furthermore, those that are available by telemedicine allow for improved access to quality and appropriate pain medication management, and additionally support opioid risk mitigation strategies, helping fill an unmet access to those at higher risk. This practice has the potential to help offset primary care provider workload, allowing for a decreased overall burden, especially in a complex, time-consuming, and high-risk patient population.
与普通人群相比,患有慢性疼痛综合征的患者面临着来自严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的额外挑战。社会隔离加剧、阿片类药物剂量相应增加以及自杀倾向/焦虑、难以获得合法药物、进行适当的综合评估、持续对阿片类药物滥用/误用进行风险分层、必要时安全地逐渐减少阿片类药物用量以及药剂师干预的其他机会等新问题已很明显。我们讨论了在这个国际紧急时期药剂师开展远程医疗问诊的机会、服务报销以及干预措施的各个方面,此时所有医疗保健专业人员都被要求挺身而出,帮助应对2019冠状病毒病的共同威胁。各个专业领域的临床药剂师都是基本医疗保健队伍的一部分,但尤其是那些从事疼痛管理的药剂师处于独特的地位,能够协助所有医疗服务提供者遵守慢性疼痛指南和各项政府规定,并为患有慢性疼痛的复杂患者促成最佳治疗效果。此外,那些通过远程医疗提供服务的药剂师能够改善优质且适当的疼痛药物管理的可及性,还能支持减轻阿片类药物风险的策略,有助于满足高风险人群未得到满足的需求。这种做法有可能帮助减轻初级保健提供者的工作量,从而降低总体负担, 特别是在复杂、耗时且高风险的患者群体中。