1. DR CLARE MAHER

2. WHAT ARE THE ISSUES?

3. ACUTE PAIN WHAT IS IT? THINK ABOUT TYPICAL PRESENTATIONS OF AUCTE PAIN TO YOU WHEN YOU WORKED AS A PHARMACIST………… WHAT DID YOU SEE?

4. CHRONIC PAIN WHAT IS IT? HOW DOES IT DIFFER FROM ACUTE PAIN? WHO GETS CHRONIC PAIN?

5. WHO GETS CHRONIC PAIN MOST POPULATION STUDIES SHOW A POINT PREVALANCE OF 12-20%. GRADE CHRONIC PAIN 1-4 IN AUSTRALIA MALES 65-69YEARS FEMALES 80-84YEARS IN ATSI WHAT HAVE PEOPLE SEEN?

6. CHRONIC PAIN= CHRONIC ILLNESS EDUCATION LIFESTYLE MODIFICATIONS MEDICATIONS

7. ASSESSMENT OF PATIENT Full History of when the pain started and what the pain is like now. Adequate treatment of acute pain (think PTSD) Features of the pain and site of the pain. Always think of neuropathic features tingling cold, hot burning. Grade the pain HOW DO YOU THINK ATSI PEOPLE WOULD ENGAGE WITH THIS SORT OF SCALE?

8. ASSESSMENT OF PATIENT Mental health 50% of patients with chronic pain have depression and or anxiety What medications have they tried? What treatments have they had?

9. SMOKING ALCOHOL ( IF PEOPLE DEPRESSED INCREASES?) OTHER DRUGS OTHER MEDICAL CONDITIONS EG DM, RENAL FAILURE, COPD OTHER HX THAT YOU MIGHT NEED? ASSESSMENT OF PATIENT

10. TREATMENT OF PATIENT Chronic disease so set goals with the patient GPMP. What are they aiming for? E.g. A good nights sleep Education e.g. diabetic neuropathy 25% of DM patients get it Commonly burns itself out in 5 years What causes it explanation to patient Good glyceamic control may assist the pain Avoid other injuries diabetic foot

11. OTHER QUESTIONS What have we missed? Other pearls? Thank you