Communication between patients and providers is key to effectively managing pain after discharge.
When patients feel the first aches of pain from their hospital bed, they can call a nurse for help. When the throbbing starts at home, relief can be limited. Hospitals have access to a variety of medications for pain, and it is typically provided at much stronger doses than what is available at your local drug store. This leaves many people either suffering in agony or going to the emergency room.
“It can be challenging to manage pain once a patient is discharged,” said Brittany Johnson, PharmD. “We can’t monitor them as closely. If they have a chronic condition like sickle cell, it can be difficult to get them the pain medications they need because of the regulations in place to prevent drug abuse.”
Johnson is the first pharmacist at UF Health Jacksonville who specifically focuses on pain management. The position was created to break down barriers caused by pain that often negatively affect a patient’s overall experience while they are receiving care.
“I analyze both the inpatient and outpatient trends related to pain management and search for any correlations between them to help us determine what can be done to improve outcomes,” Johnson said.
Tackling Pain From All Fronts
Physicians at UF Health use a multimodal approach to manage pain, with medication as just one of the components. Providers also factor in a patient’s mental health and lifestyle, such as their exercise routine, sleep schedule, smoking habits and diet, to determine if physical rehabilitation or emotional therapy is also needed.
“People think, ‘I can’t move because I am in pain,’ but typically you have pain because you are not moving, especially if your pain is caused by a specific injury,” said Maria Pattugalan, an outpatient rehab manager for UF Health Rehabilitation Services – Jacksonville. “When you stop moving, your body becomes stiff and limits your range of motion, causing more pain.”
Relieving Postoperative Pain
It is common for patients to experience pain for up to several months after surgery, but according to the American Chronic Pain Association, at least 3 to 5 percent of those cases develop into chronic or persistent pain in the area around the incision.
“It is best to control or handle acute pain aggressively to prevent it from developing into chronic pain,” said Alberto Ardon, MD, an anesthesiologist and assistant director of surgery at UF Health North. “Our team aims to minimize postoperative pain through a variety of ways, including the use of nerve blocks, non-narcotic medications such as Tylenol and narcotic analgesics.”
Communicating to Combat Pain
Often the best way to keep patients comfortable is by simply having a conversation. Physicians can provide realistic expectations to patients about the pain they may feel while they are admitted and explain what they are likely to experience when they go home.
“A lot of times patients think something is wrong if they feel anything at all,” Ardon said. “We help them understand that after a major procedure or traumatic injury it is normal to have some amount of discomfort. Our role is to make that pain as minimal and manageable as possible depending on the circumstances.”
UF Health patients who undergo surgery or are admitted to the emergency room also receive a call afterward to see how they are doing and to make any follow-up appointments they need.
“In addition, this allows us to make sure patients thoroughly understood and are following their discharge instructions,” Ardon said. “It also lets us know if further action is needed before their next appointment.”
“It’s important to ask the right questions,” Johnson said. “What type of pain did you have in the hospital, and what are you feeling at home? The answers can help us determine the cause of their pain and allows us to provide the appropriate medication to relieve it.”