Safe administration of meds is key for pain management, says expert
Wednesday October 31, 2007 -- Deron Hamel
PETERBOROUGH, Ont. - Representatives from long-term care homes throughout the surrounding Peterborough region gathered Oct. 26 to hear a presentation from an acclaimed palliative care expert.

The presentation delivered by Dr. Sol Stern, which was part of a Four Counties Long-Term Care Palliative Network meeting, focused on issues surrounding pain management in the long-term care sector.

Stern, chairman of palliative care at Halton Healthcare Services, delivered his presentation just before the start of National Pain Awareness Week, which runs Nov. 3-10.

“What we’re trying to do is raise the profile of pain management in Canada,” he told the Morning Report, adding that pain is under-diagnosed in Canada.

“I believe that we can do a better job (of managing pain), but if we’re going to do a better job and we’re going to use medications, we have to do it in the safest possible way.”

At the centre of safe, effective pain management, said Stern, is engaging staff members in best practices.

For instance, before administrating painkillers to a resident, health-care professionals need to assess the benefits and risks of giving the medication, as well as provide the resident and their family with information about the drug.

If it’s recommended a resident take Aspirin, for example, the resident needs to be aware that this medication is known to cause internal bleeding. Likewise, a resident being prescribed an opioid — such as morphine, Demerol or hydromorphone — needs to be aware that the drug can be addictive.

“The numbers show that approximately 10 to 15 per cent of the population is at risk for abusing an opioid, meaning that over 80 to 85 per cent are not,” said Stern. “Those people at high risk, you either avoid (giving them opioids) or you’re extremely careful.”

To assess risk of opioid addiction, staff members need to look into a resident’s past to see if there’s a personal or family history of addiction, such as alcoholism, said Stern.

Nancy Rooney, administrator at Caressant Care Nursing Home, McLaughlin Road site in Lindsay, said she particularly found information Stern gave about hydromorphone to be interesting.

The medication provides people suffering pain with constant relief, while providing them with less sleep interruption.

Although the drug has received criticism over the years, Rooney noted that Stern told attendees there are many benefits to hydromorphone.

“He (talked about) the positive information instead of the negative,” she said.

Following his presentation, Stern said he hoped attendees gained an understanding that there’s still work to be done assessing and treating pain. 

“I would like (attendees) to walk away with a concept that we’re doing a really good job of pain management in Canada, but we can do better,” he commented.

Kathy Donaldson, director of care at Extendicare Peterborough, said she enjoyed Stern’s presentation, noting pain management is an area the long-term care sector needs to continue to focus.

“I think there’s always room for learning,” she said.