By raising awareness of barriers to effective pain control and promoting adherence to recommended treatment strategies, consultant pharmacists can play a key role in ensuring prompt, effective relief for elderly residents with cancer and other pain-producing disorders. W idely accepted pain management guidelines recommend aggressive use of pain medication for all patients who need it, regardless of age. Given the long-term care community's apparent slowness to fully embrace the guideline, consultant pharmacists can perform an important service by educating other health care team members on recommended assessment and treatment practices, as detailed in a 1994 clinical practice guideline issued by the Agency for Health Care Policy and Research.
Considerable discussion is devoted to special management considerations for geriatric populations.
Barriers to Proper Care Understanding the many caregiver, system, and patient-related factors underlying inadequate pain management is useful in defining corrective strategies. Problems to be addressed by health care professionals include inadequate knowledge of pain managment standards, suboptimal assessment, and concern over possible violations of controlled substances laws and the patient's development of addiction or increased tolerance. Patient-related barriers include reluctance to report pain and noncompliance with pharmacotherapy. Others may exhibit a denial fueled by fear that pain always signals worsening of disease. Still others worry that calling attention to their pain will divert attention from treatment of the underlying cause.