Details of the updated APS guidelines
The American Pain Society (APS) in Glenview, IL, recently published its 2005 Quality Improvement Guidelines for the Treatment of Acute Pain and Cancer Pain in the July 25 issue of the Archives of Internal Medicine.1
Here are a few of the updated and expanded recommendations for 2005:
- Recognize and treat pain promptly. (Emphasize comprehensive assessment and importance of preventive and prompt treatment based on evidence for neuroplasticity.)
- Improve treatment patterns. (Eliminate inappropriate practices and provide multimodal therapy.)
- Reassess and adjust pain management plan as needed. (Respond not only to pain intensity but also to functional status and side effects.)
APS also recommended quality indicators and suggested measures of acute pain management. Here are two examples of the assessment and treatment of pain: - Quality indicator: Pain is treated by route other than intramuscular.
Measure: Percentage of patients receiving intramuscular injections. - Quality indicator: Pain is treated with regularly administered analgesics and, when possible, a multimodal approach is used (such as combinations of regional or local techniques, with nonopioid, opioid, adjuvant analgesics, and nonpharmacologic methods).
Measures: Percentage of patients receiving nonopioid alone, opioid alone, regional techniques (such as neuraxial), and various combinations of nonopioid, opioid, and regional techniques.
Percentage of patients receiving meperidine hydrochloride. (Patient question) Did you use any nondrug interventions in addition to analgesics to manage your pain? __ Yes __ No
If yes, please check all that apply: relaxation, meditation, heat, cold, deep breathing, walking, imagery or visualization, other (please describe).
Reference
- Gordon DB, Dahl JL, Miaskowski C, et al. American Pain Society Recommendations for Improving the Quality of Acute and Cancer Pain Management. Arch Intern Med 2005;165:1,574-1,580.
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