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Pain
Bill Update
Capitol Hill Briefing Draws 54 House Staffers
Interest
group briefings are common in Washington, DC. They give busy, often
overworked, Congressional staff members the chance to acquire information
and insight on pending legislation, and there's usually a
free box lunch.
On
June 13, the Pain Care Coalition (PCC) and the American Pain Foundation
(APF) cosponsored "The Epidemic of Pain in America"
to provide background on the problem of untreated and undertreated
chronic pain and to encourage support of HR 1020, the Pain Care
Policy Act.
According
to Penny Cowen, executive director of the American Chronic Pain
Association, the 54 staff members in attendance were receptive to
appeals made by the briefing speakers, which included HR 1020 lead
sponsor Rep. Mike Rogers of Lansing, MI., and Rep. Charles Norwood
of Augusta, GA, vice chair of the House Energy and Commerce Committee's
Subcommittee on Health, which currently is deliberating the pain
bill. Other speakers were Mac Gallagher, MD, representing the PCC,
Howard Heit, MD, a northern Virginia pain care specialist and pain
patient, and Mary Vargas, a pain patient and APF activist. The central
theme expressed by all speakers was that untreated and undertreated
chronic pain is the nation's leading public health problem and provisions
in HR 1020 will provide badly needed resources for pain research,
education, and treatment.
"It
was a good event and worth doing," said Robert Saner, legislative
liaison for PCC. "We need to keep pushing hard to recruit
cosponsors and get better partisan balance. Saner added that Rep.
Rogers is seeking more Republican cosponsors.
No
timeline has been set for Committee action to recommend the measure
for passage by the House of Representatives.
APS
Call for Symposia and Corporate Satellite Symposia Deadline is Rapidly
Approaching
 The
2007 APS Call for Symposia and Corporate Satellite Symposia has
been available online since May 31, 2006, at www.ampainsoc.org.
The submission deadline is July 26, 2006.
The
Call for Paper and Poster Abstracts will be available online beginning
September 1, 2006. The submission deadline for these abstracts is
October 27, 2006.
Online
CE Program
Pain: Current Understanding of Assessment, Management,
and Treatments
APS is pleased to announce the release of the free CE program—
Pain: Current Understanding of Assessment, Management, and Treatments.
The first version of this program, which was released in 2004, underwent
an editorial review and update. The updated program is free
on the APS Web site and is now available at
www.ampainsoc.org/ce/enduring.htm.
The
activity offers CE credits for physicians, nurses, pharmacists,
and psychologists.
Online
Directory of Fellowship Opportunities in Pain Research
 In
an effort to inform qualified candidates about training opportunities
in pain research, APS is soliciting information related to post-graduate
and post-doctoral training programs focusing on pain research. We
are interested in formal training programs with multiple faculty
and opportunities for research.
These
opportunities will then be posted on the APS Web site in a searchable
directory as a resource for those seeking fellowship opportunities
in pain research.
Click
here to link to a questionnaire that collects information about
your institution's fellowship opportunities that fit the above
criteria. Please complete this questionnaire as completely as possible
for each fellowship program by August 11.
Eastern
Pain Association Annual Scientific Meeting
 The
Eastern Pain Association's Annual Scientific Meeting will be held
September 29–30, 2006, at the Marriott East Side Hotel in
the heart of midtown Manhattan. The theme, pain communication, promises
to span the challenges of pain assessment and treatment from pediatrics
to geriatrics. The full program can be viewed by clicking
here.
Richard
Payne, MD, will be this year's recipient of the prestigious
Bonica Award. His lecture, "What is Compassionate Pain Care
in the 21st Century? Is the Good Samaritan an Oxymoron in 21st Century
Health Care?" will be presented during the lunch break on Friday,
September 29, and is open—free of charge—to all regardless
of whether they attend the rest of the meeting. James Henry, PhD,
will conclude Friday's program with a dinner lecture, "Pain
Can Become a Disease Itself," which will be the inaugural
Raymond W. Houde Lecture in honor of our esteemed colleague who
passed away in March.
On
Saturday, September 30, there will be a half-day program, Interdisciplinary
Treatment Volume 2, Focus on Headache, which is targeted toward
interns, residents, fellows, and others who are relatively new to
the practice of pain medicine or who want a refresher course with
experts in migraine and nonmigraine headache. Trainees are encouraged
to take advantage of this most interactive and unique opportunity.
Voices
of Chronic Pain Survey
Chronic pain takes a devastating toll on the lives of those who
suffer, according to new findings released by the American Pain
Foundation. Results from the Voices of Chronic Pain patient survey
reveal that more than half (51%) of chronic pain patients currently
using an opioid analgesic agent felt they had little or no control
over their pain. This survey is the first of its kind to evaluate
the attitudes and impact chronic pain has on patients who have sought
care from their physician and are currently using an opioid to treat
their pain.
For more information about the Voices of Chronic Pain survey and
chronic pain, log on to www.painfoundation.org.
Volunteer
Spotlight: Mary Ersek, PhD RN
 When
APS E-News staff reached Mary Ersek, PhD RN, she was in
Washington, DC, sitting on the steps of Smithsonian. We caught her
between meetings, coincidentally in the city that will host the
2007 APS Annual Scientific Meeting. Dr. Ersek now serves as the
Scientific Program Committee Chair and wants APS members to know
the group is planning a top-quality program.
"Washington
is a fabulous place for a scientific meeting, not only because there
is so much for families to do, but also because the close proximity
to NIH and Capitol Hill gives us the opportunity to recruit national
research and policy leaders as speakers and panelists," said Dr.
Ersek. "The planning committee has met once already and identified
key areas for sessions covering cutting-edge basic science and translational
research. However, I want to remind APS members that the meeting
will be as good as they make it, so please send in your abstracts."
Dr.
Ersek is a veteran of the APS Scientific Program Committee and became
chair this year at the urging of APS President Judy Paice. She has
enjoyed being involved in planning the annual meeting program because
the committee "brings together disparate colleagues who engage in
frank and open discussion and idea sharing. To me that is the essence
of what APS is all about."
An
APS member for more than 10 years, Dr. Ersek received her doctorate
in nursing science in 1991 from the University of Washington. She
taught undergraduate nursing students while pursuing research interests
in pain and palliative care. She won a Bonica Fellowship to further
her studies of pain and the elderly. "I have had the opportunity
to work with a wonderful group of multidisciplinary colleagues,
especially Professor Judy Turner, a widely published psychologist
who has made significant contributions in pain research. Pain is
such a complex phenomena that it requires collaborating with several
disciplines to make significant progress in delivering effective
pain management for older adults."
Dr.
Ersek currently is a research scientist at the Swedish Medical Center
in Seattle, an irresistible opportunity she says prompted her to
leave a "job for life" at the University of Washington.
APS
2006 Future Leaders in Pain Small Research Grants Program
APS
is pleased to announce the second annual Future Leaders in Pain
Small Research Grants Program. This grant program was established
to fund research projects of investigators who have a doctorate
and have not yet attained NIH RO1 level funding. The program's intent
is to encourage research in pain, which will add to the body of
knowledge and allow investigators to develop pilot data to help
them secure additional major grant funding.
APS
gratefully acknowledges Cephalon, Inc., and Endo Pharmaceuticals
for their support of this program. With increased funding, APS is
able to make five grants of $20,000 each in 2006.
Applications
are due July 21, 2006. Grant awards will be announced September
15, 2006.
For
additional information, contact APS at 847/375-4715 or info@ampainsoc.org.
Call
for 2007 Awards Nominations
The
APS Awards Committee invites nominations for awards to be presented
at the 26th Annual Scientific Meeting, May 2–5, 2007, in Washington,
DC. The committee solicits nominations for the following APS awards:
- John
and Emma Bonica Public Service Award
-
Wilbert E. Fordyce Clinical Investigator Award
-
F. W. L. Kerr Basic Science Research Award
-
Jeffrey Lawson Award for Advocacy in Children's Pain Relief
-
John C. Liebeskind Early Career Scholar Award
-
Elizabeth Narcessian Award
-
Distinguished Service Award
-
Kathleen M. Foley Journalist Award.
All
nominations must be received by July 21, 2006. Brochures and forms
were mailed in June.
News
Highlights from The Journal of Pain
Journal
of Pain subscribers are encouraged to register online
to receive an e-mail alert that includes the journal's table
of contents for upcoming issues. This e-mail alert contains
links that will direct users to full-text copies of the articles.
A recent change to the Web site's platform may have disabled
this function for users who were previously registered; it
may be necessary to reregister here.
Subscribers
also have full access to the journal's online version (including
Articles In Press, which appear online prior to publication)
at www.jpain.org. Subscriber
user names and passwords are required to activate electronic
features. To save your user name and password click the "auto
log in" box in the upper right-hand corner of the journal's
home page next time you log on. Enabling this feature will
set a "cookie" on your computer and allow the system
to recognize you next time to access the journal online. |
 The
following highlights summarize selected articles from the June 2006
issue (volume 7, number 6) of The Journal of Pain.
Cost-Effectiveness
of Duloxetine Versus Routine Treatment For U.S. Patients with Diabetic
Peripheral Neuropathic Pain
Eric Q. Wu, Howard G. Birnbaum, Milena N. Mareva, T. Kim Le,
Rebecca L. Robinson, Amy Rosen, and Steve Gelwicks, The Analysis
Group, Inc, Boston, MA
Painful
peripheral neuropathy is a common complication of diabetes. It is
estimated more than 50% of diabetic patients 60 years of age or
older experience neuropathic pain. They often have constant, daily
pain that interferes with normal life activities. This study evaluated
223 patients to assess the cost-effectiveness of duloxetine versus
routine treatment for managing pain caused by diabetic neuropathy.
Trial
subjects were randomized into a 52-week open-label study of duloxetine
dosed at 60 mg, twice daily. Routine treatment consisted of pain
management therapies using gabapentin, venlafaxine, or amitriptyline.
When total medical costs, as well as patient out-of-pocket costs
were considered, duloxetine proved to be more cost-effective than
routine treatments. These results, however, occurred in the controlled
environment of a clinical trial. The authors recommended that further
research be conducted using real-world data.
Patients'
Decision Making Strategies for Managing Postoperative Pain
Elizabeth Manias, University of Melbourne School of Nursing
This
study is the first to examine patient strategies for making decisions
about managing their pain after surgery. Common postoperative scenarios
include patients refusing to accept analgesia, behaving passively
about asking for it, and believing they have to tolerate pain. Misinformed
patient attitudes are common, such as believing that pain is necessary
for recovery and that pain occurs as a result of one's own
wrongdoing. Studies have shown that satisfaction with pain management
after surgery is highest when patients are included as informed
partners in discussions about analgesic options.
In
this study, 312 Australian post-surgical patients were surveyed
and the most common strategy observed (60%) was acting as a passive
recipient for pain relief. Problem solving and active negotiation
accounted for less than 40% of patient decision making. The author
concluded that in this post-operative environment, where patients
are confronted with unfamiliar demands and expectations, it is not
surprising they frequently deferred to nurses to offer treatment
for pain relief. Patients typically experience a sense of helplessness
while hospitalized, which can increase their overall fear and unwillingness
to communicate their pain-control needs. The author recommends that
nurses should attempt to understand this fear and develop proactive
communication tactics to help allay patient fears about pain.
Lack
of Influence of Patient Self Report of Pain Intensity on Administration
of Opioids for Suspected Long-Bone Fractures
Polly E Bijur, Anick Berard, David Esses, Jordan Nestor, Clyde
Schecter and E. John Gallagher, Albert Einstein College of Medicine,
New York
Effective
pain management can be difficult to achieve and assess because of
the subjective nature of the pain experience in individual patients.
This study evaluates the extent to which emergency care providers
base their decisions about pain management for suspected long-bone
fractures on self-reports of pain intensity. Previous research has
shown that pain is undertreated in most healthcare settings, including
emergency departments. One of the factors believed to contribute
to this problem is reliance on provider judgment about the need
for pain medication without paying sufficient attention to how patients
rate their pain. Many studies have shown that if providers are asked
to assess patient pain, their ratings are lower than patient self-reports.
Long-bone
fracture has been used as a model for studying undertreatment of
pain in the emergency department. In this study, 69 of 100 long-bone
fracture patients received opioid pain medications compared to 30%
of non-long-bone fracture patients. The researchers found the type
of medication chosen was strongly associated with diagnosis, which
supports previous findings that emergency department patients with
fractures are twice as likely to receive opioids as those without
fractures. Patients with fractures in this study had significantly
higher pain intensity ratings than those without fractures. However,
further statistical analysis showed the likelihood of being treated
with opioids was higher based on a fractures diagnosis rather than
on consideration of pain intensity self-reports.
Kinesiophobia
in Migraine
Isabel Pavao Martins, Raquel Gouveia and Elsa Parreira
Hospital de Santa Maria, Lisbon, Portugal
Kinesiophobia
is avoidance of movement to ease or prevent pain. It is common behavior
for migraine patients who often fear movement because it aggravates
pain. Some patients can differentiate migraines from normal headaches
at their onset by bending forward. If bending aggravates the pain,
it's a migraine. The researchers questioned 150 patients to determine
the frequency and severity of kinesiophobia during migraines and
its role in diagnosis. Based on the patient responses, the authors
concluded that kinesiophobia can discriminate between migraine and
tension-type headache. It may be useful to ask patients questions
about bending forward, therefore, to help them differentiate headache
attacks.
Oncology
Nursing Society Announces an Excellence in Pain Management Award
The
purpose of the award is to support and recognize an oncology nurse
for excellence in and dedication to pain management. For an application
and more information click
here.
PPSG
News Alert: Cancer Foundations Support Evaluation of U.S. Pain Policies
The
Pain and Policy Studies Group (PPSG) is pleased to announce joint
funding of its U.S. pain policy evaluation program by the American
Cancer Society, the Susan G. Komen Breast Cancer Foundation, and
the Lance Armstrong Foundation. Each of these highly respected organizations
has announced that it will provide a 3-year grant to enable the
PPSG to evaluate federal and state laws, regulations, and agency
guidelines that can affect patient access to effective pain relief.
For more information, click
here for a copy of the press release and links to the funding
organizations.
The
Wiley Prize in Biomedical Sciences
The
Wiley Prize in Biomedical Sciences recognizes contributions that
have opened new fields of research or advanced novel concepts or
their applications in a particular biomedical discipline. The award
may recognize a specific contribution or a series of contributions
that demonstrate the nominee's significant leadership in the development
of research concepts or their clinical application. The award will
consist of a $25,000 grant and each year's recipient will deliver
a lecture at The Rockefeller University. Nominations are due July
31, 2006. For more information, click
here.
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