Home' Australian Pharmacist : Australian Pharmacist June 2016 Contents Australian Pharmacist June 2016 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
1. Which ONE of the following
statements is TRUE about the
prevalence of back pain in Australia?
a) The prevalence of lower back pain in
Australia is low by global standards.
b) The current prevalence of lower back
pain in Australia is not known.
c) Less than 5% of people experiencing
lower back pain will experience
d) Arthritis and musculoskeletal conditions
are a National Health Priority Area with
the largest share of its cost borne by the
person suffering the pain.
2. Which ONE of the following
statements BEST summarises how
pharmacists can assist patients with
a chronic pain condition?
a) Use assessment tools to identify any
underlying serious pathology and
b) Identify any analgesic overuse by the
c) Use evidence-based management
principles, encourage patient self-
management and routinely follow-up
with the patient.
d) Identify barriers that impede the
patient’s return to work, and consider
their attitude to rehabilitation.
3. Good management of acute
exacerbation of lower back pain
a) Full bed rest until symptoms are
completely resolved then a slow
increase in activity until normal activities
can be resumed.
b) Modified normal activities, short-term
use of simple analgesics, continuous
heat wrap application for three days, use
of relaxation techniques and avoidance
of excessive bed rest.
c) An increase in activities to avoid
deconditioning, maximising the use of
long-acting analgesics for 2–3 months
and a maintenance of full work capacity.
d) No limit to normal activities, weekly
visits to the physical therapist,
continuing regular physiotherapist visits
for spinal manipulation until the pain
resolves and increased use of short-
acting analgesics if such interventions
4. Which ONE of the following
statements BEST describes the
most appropriate examples of
health promotion activities for pain
management within community
a) Providing MedsChecks focusing on pain
b) Providing consumer medicines
information (CMI) each time an
over-the-counter (OTC) analgesic is
c) Telephoning patients or sending SMS
text messages reminding them that
opioid therapy is dangerous and that
usage should be limited to short-term
d) Assessing patients at risk of poor pain
control, promoting healthy behaviours
relevant to managing pain and guiding
patients to adjunct pharmacy services.
5. Which ONE of the following
statements is TRUE of pain
a) Reviewing a patient’s self-recorded
pain diary is the most accurate way of
assessing their pain.
b) The Opioid risk tool helps the pharmacist
assess the patient’s risk of developing
adverse effects to opioids.
c) A single red flag indicator will require
specialist referral to exclude serious
d) Yellow and red flags should be used as
assessment tools to help the pharmacist
exclude serious pathology and identify
psychosocial contributors to persistent
In Andrew’s case, assuming that there
is no serious pathology, reassurance
should be provided that he is going
through an acute ‘flare-up’ of his
lower back pain and simple analgesia
such as paracetamol 1 g qid is the
recommended first-line treatment.
drugs (NSAIDs) or combination
simple analgesics can be considered
if paracetamol does not effectively
manage the pain. The use of these
simple analgesics should be reviewed
within 1–2 weeks. It would be important
to determine if Andrew is opioid naïve
and to discuss with him the role of
OxyContin (oxycodone). If the script for
OxyContin continues to be filled, the
duration of use should be for the short-
term only. It would be important to have
an agreement with Andrew to reduce
the OxyContin dose in a couple of weeks.
Discussions with the GP may be also
worthwhile so that there is collaborative
understanding and support for Andrew.
Applying regular heat packs or heat
wraps, seeing a physiotherapist for spinal
manipulation and having a movement
plan for ongoing self-management of
the condition is essential. Ergonomic
education by the physiotherapist will
also be valuable to ensure that Andrew
understands how to apply his movement
planning in the workplace. Andrew
should be supported with education of
his condition so that he can participate
actively in his own self-care.
Managing acute and persistent pain
is complex and requires a multimodal
approach. Pharmacists can play a
significant role in guiding the patient
in rationalising analgesic therapy
and improving their understanding
of managing pain for better self-
A comprehensive pain management
service within a community pharmacy
can involve individualised care and
health promotion strategies that
encourage collaborative partnerships
with other allied health professionals
within the community.
References located on page 76.
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