A new program to help people manage pain by using a combination of traditional methods mixed with new coaching and education has been established at UF Health Jacksonville. The new initiative is a collaboration between emergency medicine providers and a grant from the Florida Department of Health.
For those battling pain, the first instinct may be to open the medicine cabinet or ask for a prescription to find relief. For many living with pain, the use of medication alone is not always the best solution. Recent estimates indicate chronic pain affects 50 million adults in the U.S. and this does not take into account cases that are acute in nature based on injuries commonly seen in the emergency room.
Retail pharmacies and stores are not always easy to navigate due to dozens of products on the shelf marketed for pain relief. Amid the opioid epidemic in the U.S., many patients and providers are also searching for non-medication pain management options with fewer side effects and risk for addiction. Where do you turn when you are flooded with options and the need to return to work or activities of daily living?
The Pain Assessment and Management Initiative Pain and Opioid Stewardship Education program, or PAMI POST-Ed, was established through a 2020 Overdose Data to Action award to develop and implement a novel pain coaching and education model. Launched in January, it is the first known pain coaching program implemented in a U.S. emergency room.
Overdose Data to Action, or OD2A, is part of a cooperative agreement to address the drug overdose epidemic with the Centers for Disease Control and Prevention providing funding to the Florida Department of Health in Duval County. PAMI POST-Ed is sponsored by the state of Florida Department of Health.
Douglas Suffield, MAcOM, DiplOM, L.Ac., was hired in October 2020 as the program’s pain education specialist. He is a former emergency medical responder and is board-certified in acupuncture and oriental medicine. In his role, he provides patient consultations in the emergency department at UF Health Jacksonville and UF Health North and hospital inpatient units.
“My hope is to educate, coach and guide patients toward a better understanding of the way they identify and experience their pain,” Suffield said. “By utilizing my experience as an integrative health provider, our toolkit of multimodal pain management interventions, and interdepartmental communication and cooperation, I have no doubt this initiative will be a success and improve the way patients understand and manage pain.”
An integral part of the coaching experience is the hands-on training Suffield brings to patients — teaching them about pain neuroscience, topical analgesics, deep breathing exercises, virtual reality and other complementary health approaches. Often viewed as Eastern medicine, Suffield and the POST-Ed team will work to integrate this approach alongside traditional pain management practices to holistically guide patients in achieving an improved approach to pain management.
The program is a joint multidisciplinary effort with stakeholders and advisors from pharmacy, rehabilitative services, nursing, chaplaincy, palliative care, pain management, emergency services and trauma.
“This program is a winning strategy and collaborative partnership for patients and health care providers. It has been well received by our faculty, staff and patients and provides valuable adjuncts to incorporate into a more comprehensive pain management treatment plan while reducing the dose or need for opioids," said Ashley Norse, M.D., associate chair of operation for emergency medicine.
Suffield also provides patients with a toolkit of pain self-management options and educational materials for use at home. The toolkit is tailored to patient interest, type of pain and individual needs. Toolkit options include a virtual reality viewer, aromatherapy inhaler, pain analogy and stress device called “A car with four flat tires,” a hot and cold reusable gel pack, hand acupressure device, pain journal and a choice of 17 educational brochures.
Established in 2014 by Phyllis Hendry, M.D., a professor and associate chair for research in the department of emergency medicine and Sophia Sheikh, M.D., an assistant professor of emergency medicine, medical toxicologist and medical director of the Florida/USVI Poison Information Center – Jacksonville, the PAMI program has previously developed toolkits and patient resources to assist with patient discharge planning for pain. The POST-Ed project is the newest addition to PAMI and continues the program’s mission of advancing innovation and safety in pain education, patient care and research.
“We are appreciative of having been selected as an OD2A grantee by DOH-Duval for this innovative project aimed at curbing the pain and opioid epidemic,” Hendry said. “Doug was the ideal candidate for our first pain educator position especially given his extensive integrative education and patient experience. Our team looks forward to expanding the program and sharing pilot materials and lessons learned with other health care systems.”
Phyllis L. Hendry, MD, FAAP, FACEP
Associate Chair of Research
Associate Chair, Clinical Operations; Medical Director, Emergency Medicine Clinical Center