Promoting self-care for acute pain

Patients should be encouraged to self-care for a range of acute pain conditions. However, given the variety of over-the-counter (OTC) analgesics available, appropriate selection can be confusing.

In each patient consultation, including those where the patient asks for a product by name, the pharmacy team member must ensure they have all the relevant information and are making recommendations based on patient presentation and preference, alongside the latest evidence and guidance.

Best practice for pharmacy consultations

The five steps and treatment summaries outlined below and in the learning resource (available to download
here
) can be used to achieve best practice for acute pain consultations in the pharmacy.

1. Gather information

• Use the WWHAM (Who? What? How? Action? Medicines?) questioning approach;
• Avoid the scripted nature of these questions by talking to the patient and including them in the conversation. Repeat back your understanding for confirmation;
• Listen carefully to the patient — they will often provide you with answers to some of the questions before you ask them.

2. Ask questions related to acute pain symptoms

Seek to clarify:

• Its location;
• Duration and onset;
• Intensity;
• What the pain feels like;
• Its impact on day-to-day life;
• The details of any previous treatment.

3. Eliminate potential red flag symptoms

If the patient is experiencing any of the following symptoms, refer them to their GP or urgent care immediately.

• Pain from the central spinal pain region;
• Difficulty breathing;
• Dizziness or visual disturbance;
• Gradual onset or worsening of pain;
• Headache that worsens on standing or lying down;
• History of recent physical trauma;
• Loss of physical function, particularly asymmetrical;
• Neck pain or stiffness with photophobia (i.e. sensitivity to light);
• Sudden onset severe headache, reaching maximum intensity within five minutes;
• Unexplained weight loss.

4. Discuss the treatment options

Outline:

• Benefits of treatment;
• Timeframes for therapeutic effect;
• Risks;
• Alternative treatments (e.g. non-pharmacological and lifestyle);
• What might happen if the patient does nothing.

For a summary of the recommended analgesia for common acute pain conditions and important points to remember, see Box.

5. Summarise and close consultation

• Provide the patient with an opportunity to ask questions;
• Reassure the patient that they can contact the pharmacy if they have any concerns or questions;
• Check the patient knows when to seek further help.

Important considerations relating to analgesic recommendations in pharmacy

The table, included on page two of the learning resource, provides more information on the indications, cautions and additional information related to the use of NSAIDs (ibuprofen and aspirin), paracetamol and codeine^{[1],[2],[4],[5],[6]
[7],[8],[9],[10],[11],[12],[13],[14],[15],[16],[17],[18]}
.

Download the learning resource here
.   

VIVA CODE: RB-M-15129

Date of preparation: September 2020