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A pharmacist’s role in managing chronic pain goes beyond medication
management to coordination and signposting.
Pharmacy is experiencing a period of
change, complexity, and uncertainty.
Health policy and funding models are
changing. Multidisciplinary care, self-
management and innovative services
for people with chronic conditions were
the focus of a 2016 Grattan Institute
report which concluded that: ‘Significant
improvements in the quality of care
and outcomes for people with chronic
conditions can be realised particularly
through strengthening integrated care
in primary care settings.’
An example of such improvements is the
Turning PAIN into GAIN program provided
by the Gold Coast Primary Health
Network (GCPHN) in collaboration
with accredited pharmacist Joyce
McSwan. This is a truly multidisciplinary
program involving consultant clinical
pharmacists, physiotherapists, exercise
physiologists, psychologists, dieticians
and general practitioners (GP) all of
whom have a special interest in pain
management. It was designed by and
is coordinated by Joyce. The program
consists of: educational sessions
presented by Joyce and other health
professionals from the multidisciplinary
team; up to five additional allied health
services paid for by the GCPHN; and
individual face-to-face discussions to
support participants and guide them
to identify the additional allied health
services that would benefit them most.3
The program has been running for
about three years and results are
impressive when compared with other
programs designed to help patients
manage chronic pain.
A pilot study
commenced in September 2013. A total
of 103 patients were identified from
Gold Coast University Hospital wait
lists for persistent pain, orthopaedics,
rheumatology and neurology, or were
referred by their GP. The 48 patients who
enrolled in the program had an average
age of 55 years, and pain duration of
12.9 years, 38 were female.
During the pilot program they had
access to two individual discussions and
10 monthly evidence-based education
and information sessions. Large clinically
significant improvements in pain
self-efficacy5 were reported.
Participants felt better equipped i.e.
more motivated, knowledgeable and
empowered, to self-manage their
pain.3 A follow up questionnaire sent
to the second group of participants
showed that 97% of those responding
experienced some improvement.
These findings resonate with the Grattan
Strengthening integrated care in
BY DR MICHELLE KING
Institute’s conclusion and indicate the
future of healthcare.
Chronic pain affects almost one in
Many are regular
customers of community pharmacy due
to their use of pain relieving medicines.
Access to specialist multidisciplinary
hospital-based pain management clinics
is limited, resulting in long waits for all
but the most severe cases. The Turning
PAIN into GAIN program shows that
collaboration between pharmacists and
other health professionals can make a
difference to those people.
Elements of the Grattan Institute
report are being adopted into health
policy, opening up opportunities for
pharmacists wanting to become more
involved in multidisciplinary care.
1. Woods P, Gapp R, King MA. A grounded exploration of the
dimensions of managerial capability: A preliminary study of
top Australian pharmacist owner-managers. Res Soc Adm
2. Swerissen H, Duckett S, Wright J. Chronic failure in primary
medical care: Grattan Institute, 2016.
3. King MA, Sav A, J M. A pilot study of a multidisciplinary
clinical pain programme provided by the Gold Coast
Medicare Local. Int J Pharm Pract 2015;23((Suppl. S1)):7.
4. Jackson T, Wang Y, Wang Y, et al. Self-Efficacy and Chronic
Pain Outcomes: A Meta-Analytic Review. The Journal of
5. Nicholas MK. The pain self-efficacy questionnaire:
Taking pain into account. European Journal of Pain
6. King MA, Mey M. Assessment of the 2014-2015 persistent
pain program provided by the Gold Coast Primary Health
Network: Turning pain into gain. Gold Coast: Griffith
7. Blyth FM, March LM, Brnabic AJ, et al. Chronic pain in
Australia: a prevalence study. Pain 2001;89(2-3):127–34.
Dr Michelle King is a Senior Lecturer at Griffith
University. She has been working with Joyce McSwan
and the Gold Coast Primary Health Network to
evaluate the Turning PAIN into GAIN program.
» ACCREDITED PHARMACIST SPECIAL INTEREST GROUP
The program has been
running for about three
years and results are
impressive when compared
with other programs
designed to help patients
manage chronic pain.
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