A Clinical Decision Made by a Pain Pharmacist

Hey there 👋🏻

We’ve been thinking about how to help people better understand what we do at PainRx. If I just told you we’re pain pharmacists, that probably wouldn’t give you a clear picture either.

Think about it—does your facility or institution have someone dedicated to managing pain medications called “a pain pharmacist”? If not, it’s hard to visualize what we actually do, or what we’re capable of doing.

So what makes me and my partner different from just pharmacists when it comes to pain medications?

When I make a clinical decision, here’s what I take seriously:

• Age

• Organ function

• History of pain medication trials

• The dose at which those trials happened

• Co-existing psychiatric conditions

  
  

When I think about age, I don’t just think about falls. Falls matter—but are we also asking what the patient wants when they’re 84? If the medication comes with side effects, but they’re near the end of their journey, does that change the conversation? These are the conversations that need to happen.

When it comes to opioid dosing, there’s even more to consider:

• Expectations

• How long they’ve been on opioids

• Drug-drug interactions, especially with benzodiazepines

  
  

Expectation setting with patients is part of the process too. What’s realistic? What goals are harder to achieve and may require more self-motivation?

If you’re noticing a pattern—it’s this:

Pain pharmacists make clinical decisions based on two things: the information we gather from the chart and the information we gather by asking the right questions.

That means if you ask enough of the right questions, you can make better decisions about pain medications, just like a pain pharmacist.

Here’s an exercise for you to try out:

Ask your next 5 patients about their pain. And really be curious about their story.

Let me know in the comment how that goes.