Amid COVID-19 crisis, pain therapeutics telehealth services by pharmacist clinicians fill unique void and mitigate risk.

Medicine access @ point of care Pub Date : 2020-08-15 eCollection Date: 2020-01-01 DOI:10.1177/2399202620947035
Jeffrey Bettinger, Jacqueline Cleary, Jeffrey Fudin
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Abstract

Patients with chronic pain syndromes are facing additional challenges from syndrome coronavirus 2 (SARS-CoV-2) virus compared with the general population. New reasons for compounded social isolation and commensurate opioid dose creeping and suicidality/anxiety, difficulty in obtaining legitimate medications, proper comprehensive evaluations, ongoing opioid risk stratification for opioid abuse/misuse, safe opioid tapers if necessary, and other opportunities for pharmacist intervention are clear. We discuss opportunities for pharmacist-run telehealth visits, reimbursement for services, and various aspects of interventions during this time of international emergency where all healthcare professionals have been asked to step up to help combat the mutual threat of COVID19. Clinical pharmacists in every specialty area are part of the essential healthcare workforce, but those practicing pain management in particular are in unique positions to assist all providers in adhering to chronic pain guidelines and various government mandates, and to foster optimal outcomes to complex patients with chronic pain. Furthermore, those that are available by telemedicine allow for improved access to quality and appropriate pain medication management, and additionally support opioid risk mitigation strategies, helping fill an unmet access to those at higher risk. This practice has the potential to help offset primary care provider workload, allowing for a decreased overall burden, especially in a complex, time-consuming, and high-risk patient population.

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在 COVID-19 危机中,药剂师临床医生提供的疼痛治疗远程保健服务填补了这一独特的空白并降低了风险。
与普通人群相比,慢性疼痛综合征患者正面临着冠状病毒综合征 2(SARS-CoV-2)病毒带来的额外挑战。新的社会隔离原因、阿片类药物剂量攀升、自杀/焦虑、难以获得合法药物、适当的综合评估、阿片类药物滥用/误用的持续风险分层、必要时阿片类药物的安全减量,以及药剂师干预的其他机会都是显而易见的。我们讨论了药剂师远程医疗访问的机会、服务报销以及在国际紧急状况下干预的各个方面,在这一时期,所有医疗保健专业人员都被要求挺身而出,帮助对抗 COVID19 的共同威胁。每个专业领域的临床药剂师都是基本医疗保健队伍的一部分,但从事疼痛管理的药剂师尤其处于独特的位置,可以协助所有医疗服务提供者遵守慢性疼痛指南和各种政府规定,并为复杂的慢性疼痛患者提供最佳治疗效果。此外,通过远程医疗提供的医疗服务可以改善高质量和适当的疼痛药物管理,还能支持阿片类药物风险缓解战略,帮助填补高风险人群的未满足需求。这种做法有可能帮助减轻初级保健提供者的工作量,从而减轻总体负担,尤其是在复杂、耗时和高风险的患者群体中。
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