Toward Better Pain Management: The Development of a “Pain Stewardship Program” in a Tertiary Children’s Hospital

Abstract

An electronic health record-based pain stewardship program is an important step in identifying all children in the hospital with undermanaged pain, and it provides a warning system that may improve patient care, outcomes, and satisfaction.

Children's cancer pain in a world of the opioid epidemic: Challenges and opportunities

“…The lack of guidelines for pediatric patients with cancer should be a call to clinicians, investigators, and professional associations to come together to develop clear guidelines for management of cancer pain in children and adolescents. Opioid stewardship programs that involve a collaborative effort of multidisciplinary stakeholders have shown promise in optimizing pain management . Stewardship programs have been adopted in the hospital setting to ensure appropriate treatment of patients.…”

“…These programs require the concerted efforts of a multidisciplinary team, including a commitment by hospital leadership, and the need for an identified leader of the program . Similarly, hospitals are beginning to adopt pain stewardship programs, led by pharmacists, in order to provide oversight for analgesic prescriptions and regimens to optimize pain management and reduce errors . Pharmacists can play a vital role in optimizing pain management and improving medication safety through customizing analgesic medications to the needs of the patient and clinical context and providing necessary patient education .…”

“…Pharmacists can play a vital role in optimizing pain management and improving medication safety through customizing analgesic medications to the needs of the patient and clinical context and providing necessary patient education . The development and implementation of such stewardship programs generally involve creating a multidisciplinary team to identify barriers to optimal pain management, determine which patients may be at most risk for suboptimal pain management, and enact evidence‐based pain management practices that are disseminated through electronic medical record order sets and clinical services . Such programs have been shown to improve opioid safety by reducing reliance on opioids for both acute and chronic pain, and efforts by hospitals to adopt opioid stewardship programs may lead to improved care and safety of pain management in patients with cancer.…”

“…Opioid stewardship programs that involve a collaborative effort of multidisciplinary stakeholders have shown promise in optimizing pain management. 43 Stewardship programs have been adopted in the hospital setting to ensure appropriate treatment of patients. For example, antibiotic stewardship programs have been implemented in hospitals across the United States to ensure optimal prescribing of antibiotics in an effort to combat antibiotic resistance.…”

“…44 Similarly, hospitals are beginning to adopt pain stewardship programs, led by pharmacists, in order to provide oversight for analgesic prescriptions and regimens to optimize pain management and reduce errors. 43 Pharmacists can play a vital role in optimizing pain management and improving medication safety through customizing analgesic medications to the needs of the patient and clinical context and providing necessary patient education. 45 The development and implementation of such stewardship programs generally involve creating a multidisciplinary team to identify barriers to optimal pain management, determine which patients may be at most risk for suboptimal pain management, and enact evidence-based pain management practices that are disseminated through electronic medical record order sets and clinical services.…”