APS Responds to Washington State Guidelines on Opioid Dosing

The APS Board recently invited the Pharmacotherapy Special Interest Group (SIG) to review opioid dosing guidelines published last March by the Washington State Agency Medical Directors' Group (AMDG). The APS Board carefully considered the SIG's response to the state guidelines and wrote a letter that was recently sent to the AMDG. Click here to view the response.

The Journal of Pain Highlights

The following highlights summarize selected articles from the August 2007 issue (volume 9, number 8).

People in Pain: How Do They Seek Relief?
Qiuling Shi, Gary Langer, Jon Cohen, and Charles S. Cleeland, University of Texas M.D. Anderson Cancer Center and ABC News Polling Unit

Nearly one in three Americans report they recently experienced moderate to severe pain and while most sought medical attention, only half of the pain sufferers said they got significant relief, according to new research published in The Journal of Pain.

Of 1,204 survey respondents polled by ABC News, 31% said they had experienced moderate to severe pain recently. Three in four reported seeking medical attention, and 92% also tried alternatives such as over-the-counter pain medications, home remedies, bed rest, prayer, and going to a chiropractor. For those who sought medical attention, only 56% said they experienced good pain relief. Difficulties communicating with physicians about pain and lack of health insurance were identified as the major obstacles to obtaining significant pain relief.

Among alternative methods cited by respondents with recent pain, prayer was used by almost half, and nearly half of that group said they achieved pain relief by praying. Previous studies have concluded that prayer and spirituality may improve the ability to cope with pain and relieve stress.

The Role of Angina Pectoris in Chronic Pain After Coronary Artery Bypass Graft Surgery
Monique A.H. Steegers, Addy van de Luijtgaarden, Luc Noyez, Gert-jan Scheffer, and Oliver H.G. Wilder-Smith, Radboud University Nijmegen Medical Centre, Nimegen, The Netherlands

A team of Dutch pain researchers has reported that angina pectoris is linked with chronic pain experienced by coronary artery bypass surgery patients. They studied 369 individuals who had bypass surgery and found that 39% had chronic pain 3 months after the procedure and 32% still had pain at 6 months.

The key finding of the study, however, was a higher incidence of angina pectoris identified in patients with chronic pain following bypass surgery. The authors noted angina may sensitize the central nervous system and promote development of chronic pain. They also wrote that bypass patients without angina could be better able to inhibit the onset of chronic pain. The study clearly shows that angina pectoris should be considered a risk factor for developing chronic pain following coronary bypass surgery.

Chronic Pain in Multiple Sclerosis: Prevalence, Characteristics, and Impact on Quality of Life in an Australian Cohort
Fary Khan and Julie Pallant, Royal Melbourne Hospital, Melbourne, Australia

Even though pain is regarded as a common problem in patients with multiple sclerosis (MS), its impact on physical and psychosocial functioning is not well understood, according to researchers from Australia's Royal Melbourne Hospital. They studied 94 patients with MS to understand the prevalence of chronic pain in this group and determine its impact on physical and psychosocial function.

Sixty-four percent of the MS patients reported chronic pain and their mean pain intensity score was 5 or moderate. Compared to MS patients who reported no pain, those in pain showed a significant difference in their psychological well being scores as measured by the Assessment of Quality of Life Scale. Further, the ability to live independently was higher in patients reporting no pain or low pain intensity.

The authors concluded pain is a significant problem associated with multiple sclerosis and clinicians should identify patients with MS who are at risk for chronic pain to facilitate timely intervention and prevent pain-related disability.

JOP Announces New Cover Art

Beginning with the January 2008 issue, The Journal of Pain will publish appropriate images on the journal cover. Selected figures may accompany a submitted manuscript (authors should make a note in the cover letter) or images may be submitted individually. Please present your art for consideration. Visit http://ees.elsevier.com/jpain to upload your materials or submit your art via email at jpain@jpain.us.

The Mayday Fund Announces 2007–2008 Fellows

The Mayday Fund announced the selection of six experts in pain management to be fellows under The Mayday Pain and Society Fellowship. The new fellows hail from across the United States and Canada, specializing in a wide range of healthcare disciplines including emergency medicine, anesthesiology, neurology, psychiatry and pediatrics.

APS extends special congratulations to the five new fellows— Elizabeth Ely, Edward Michna, Anne Louise Oaklander, Paula Tanabe, and Jennie Ching-I Tsao—who are APS members.

Established in 2003, the fellowship provides leaders in the pain management field with tools and skills to advocate on behalf of better treatment for pain. Fellows learn how to better communicate with media and policy makers and raise visibility for their issues. To date, the program has supported 18 fellows. The Mayday Fund will fund the fellowship through 2009.

2007–2008 Fellows
Elizabeth Ely, PhD RN
Children's Hospital of Philadelphia
Mary Elizabeth Lynch, MD
Dalhousie University and Queen Elizabeth II Health Sciences Centre and Capital District Health Authority
Edward Michna, MD JD
Harvard Medical School and Brigham and Women's Hospital
Anne Louise Oaklander, MD PhD
Harvard Medical School and Massachusetts General Hospital
Paula Tanabe, PhD RN
Feinberg School of Medicine at Northwestern University
Jennie Ching-I Tsao, PhD
UCLA Pediatric Pain Program

Applications will be accepted for the fifth year of the Mayday Fellowship in early 2008. Six more applicants will be chosen. For more information, visit www.maydayfellows.org.

Urgent Need for Pain Control in HIV/AIDS

Recognition of the need for pain control and palliative care in patients with HIV/AIDS is emerging, according to two recent issues of Cancer Pain Release, the publication of the WHO Pain and Palliative Care Communication Program.

In the first issue, professor Peter Selwyn, Palliative Care Program Director at Montefiore Medical Center and Department of Family Medicine Chair at the Albert Einstein College of Medicine, explains the importance of developing the knowledge and skills to deliver effective pain control and palliative care together with antiretroviral therapy to provide the best quality of life for adult patients with HIV/AIDS. The challenge of providing pain control is discussed in light of an HIV epidemic characterized by a high incidence of symptoms, a large population of patients with limited resources, and a significant percentage of patients with a history of substance abuse.

In the second issue, professor James Oleske, APS member and leading U.S. expert in the medical management of HIV-infected children, discusses how palliative care supports the effectiveness of antiretroviral therapy by controlling painful symptoms, addressing toxicity and the side effects of therapy and improving quality of life. The publication provides resources for symptom control in pediatric HIV/AIDS from WHO and other sources relevant to countries with limited resources, as well as abstracts of current research on HIV-related pain and palliative care in children.

To read these two publications online, visit www.WHOcancerpain.wisc.edu/eng/19_4/19_4.html [pain in adults with HIV/AIDS] and www.WHOcancerpain.wisc.edu/eng/20_1-2/20_1-2.html [pain in children with HIV/AIDS].

Source: WHO Collaborating Center for Policy & Communications in Cancer Care, University of Wisconsin School of Medicine and Public Health, Paul P. Carbone Comprehensive Cancer Center

National Headache Foundation Research Grants

The National Headache Foundation supports research in the field of headache and pain as a part of its basic mission, which also includes providing education and information helpful to headache sufferers. The foundation annually invites the submission of abstracts of research proposals in its area of interest. The foundation is interested in research protocols that are objectively sound, the results of which, when published in the medical literature, can contribute to the better understanding and treatment of headache and pain.

For more information visit www.headaches.org/professional/educationindex.html.

NIH Funding Opportunity
Exceptional, Unconventional Research Enabling Knowledge Acceleration (EUREKA) (R01)

The NIH seeks applications (RFA-GM-08-002) for innovative, high-impact research. For more information, visit http://grants.nih.gov/grants/guide/rfa-files/RFA-GM-08-002.html.

University of Wisconsin PPSG Releases New Publications

The University of Wisconsin Pain & Policy Studies Group (PPSG) recently announced the release of two publications, which are part of its ongoing pain and public policy research program:

• Achieving Balance in Federal and State Pain Policy: A Guide to Evaluation (4th ed.)
• Achieving Balance in State Pain Policy: A Progress Report Card (3rd ed.)

These tools can be used by government and nongovernment organizations, as well as policy-makers, healthcare professionals, and advocates to understand the policies in their state that reinforce the right to pain management, or that can hinder patient access to effective treatment.

To view or download these reports visit the PPSG at www.painpolicy.wisc.edu.

APS Call for Paper and Poster Abstracts

The Call for Paper and Poster Abstracts for the 27th Annual Scientific Meeting, May 7–10, 2008 in Tampa, FL, will be available on the APS Web site beginning Tuesday, September 4. Abstracts can be submitted until 11:59 PM Pacific time on Tuesday, October 30.

Share APS Membership Information with a Colleague

Members recently received a copy of the newly redesigned membership brochure. Take a moment to share this information about the society with a colleague.

Pain Awareness Month

Next month is Pain Awareness Month. To mark the occasion APS E-News will publish an extra issue. Look for coverage of this year's global theme of women in pain and updates about the ways that the society is working toward achieving its vision of a world where pain prevention and relief are available to all people.