REHAB 537: Integrating and Implementing Pain Management Models Summary Report
My name is Giovanni Ursella, and I am a pharmacist at the Cross Cancer Institute in Edmonton. I have been working there for a little over two years, mostly in the outpatient dispensary. The course that I completed with funds from the CAPhO learning grant was REHAB 537: Integrating and Implementing Pain Management Models, an online course offered through the University of Alberta. It is the final course in a series of three that make up a pain management certificate.
REHAB 537 focused on two main concepts: analysis of literature and translating literature to practice; and comprehensive pain management strategies. The most useful aspect of the course to me was viewing chronic pain through a biopsychosocial lens, acknowledging the multimodal nature of chronic pain management and stressing goals of therapy outside of the pain itself (since chronic pain is not reflective of tissue damage; namely, functional goals). A large part of the course reviewed different treatment modalities and had us apply them to cases. We discussed pharmacotherapy (from the conventional opioid therapy to the less-mainstream cannabinoid therapy), psychotherapy (such as cognitive behavioural therapy and acceptance and commitment therapy), self-management skills (and preparing a “flare-up toolkit” with reminders of skills or activities for managing a pain flare-up), physical activity (any movement that a patient likes and will spend time doing routinely, and that is challenging enough to cause discomfort but doesn’t go so far as to cause a pain flare-up), and other treatment modalities.
I am most definitely not proficient in all of the above therapies, and not all of these treatments are necessarily helpful for every patient, but I would consider all of them valid options to consider as part of a patient’s chronic pain management plan. And I can see the need for many options, since there simply does not exist one treatment that is guaranteed to eliminate pain and restore function. I anticipate the effective management of any patient’s chronic pain to involve multiple practitioners. My classmates came from various backgrounds—psychologists, physiotherapists, physicians, pharmacists, exercise physiologists, nursing, dentistry, and others—and now being able to recognize a broader set of therapeutic options, I see more clearly how interdisciplinary pain management can work. In being a pharmacist, I gravitate toward medications, and I found the interdisciplinary nature of the course to enable me to open up my perspective of pain management for more comprehensive care.
As broad as the class was, it also offered assignments that could be made more specific to my practice, and I was able to do one of my assignments on chemotherapy-induced peripheral neuropathy. I unfortunately don’t work closely with patients’ pain right now in the outpatient dispensary; however, I did recently have a patient happen to mention a neuropathy in her legs that hadn’t responded well to medications, and directly as a result of the course, I had the knowledge and confidence to encourage her to explore physiotherapy and psychotherapy. So, I and at least one patient have already seen benefit from this course!
I am very grateful to CAPhO for offering learning grants in 2020. Thank you for funding a step towards my development as a pharmacist! With this course, I feel better prepared to participate in my patients’ pain management.