Televideo Health Provides Painless Opportunities for Patients in Pain
By Dr. Jeffrey Fudin
Televideo offers an enhanced option for patient visits, particularly with chronic illness where travel to a clinic can make things worse – in particular, chronic pain syndromes and situations where exposure to others elevates infectious risk for office staff and patients. In the wake of COVID-19, there has been an exodus from clinic visits to televideo, in an effort to reduce the contagion and possible ubiquitous transmission of this deadly disease to patients and clinicians.
Throughout the world, elective surgeries and procedures have been delayed, much to the chagrin of the profit-drive health system I see here within the U.S., although as an American, profiteers are on the bottom of my list for the balance between in-person or virtual medicine.
I recently had an opportunity with two colleagues to outline how pain therapeutics telehealth services led by pharmacist clinicians can fill a unique void and mitigate risks in the face of this COVID-19 pandemic. Collectively all three authors are US based clinical pharmacists specializing in medication pain therapeutics, something we don’t see much, or at all, within the UK. It is noteworthy whilst we have collectively observed that overall impact of coronavirus on chronic pain patients remains unclear, there is no doubt of increased social isolation, lack of medical and behavioral health priority, lack of overall support, and increased access to opioids (because of softened regulation and diminished monitoring during COVID) have impacted patients. Considering all these issues coupled with other sedative-hypnotics and increased anxiety, it is a perfect storm for poor outcomes, and could serve to fuel an underpinning worldwide opioid epidemic. Chronic pain converging with opioid usage (legitimate and over/under prescribing) continues to be a growing and ongoing public health crisis, given chronic pain is already among the most common, costly, and disabling medical conditions as we outlined in the article.
As luck would have it, shortly following the publication noted above, I had the opportunity to speak by webinar to several long-term chronic pain patients in real time through a Zoom webinar entitled Pain care during COVID: A Q&A about telehealth, arranged by the US Pain Foundation. This was particularly enlightening because if fostered significant Q & A amongst participants with various pain issues of their own that went beyond my anticipated topics – things like hardware and software needs/compatibility, ability to perform virtual exams, what the federal Medicare system would pay for, conflicting federal versus state regulations, medication access following a televideo visit, and much more. But perhaps the most compelling question, particularly within a profit-driven system was, “When COVID is over, will we still have telemedicine?
In these uncertain times, it is quite certain that clinical pharmacists and various medical clinicians are in a unique position to address several of these growing concerns regarding pain management via televideo that have otherwise been derailed by COVID-19. With certainty, televideo enhances patient access to pain management specialists in a population of [frequently isolated] pain patients that otherwise lack access to the most qualified clinicians countrywide and in fact worldwide. Moreover, for primary care providers that are increasingly less comfortable prescribing long-term opioid therapy due to the inherent risks and associated regulatory scrutiny, having a well-trained pain clinician in your back pocket that can guide less qualified or time constrained clinicians, and also provide a written electronic note is priceless to all involved.
Article details
Amid COVID-19 crisis, pain therapeutics telehealth services by pharmacist clinicians fill unique void and mitigate risk
Jeffrey Bettinger, Jacqueline Clearly, Jeffrey Fudin
First Published August 15, 2020 Review Article
DOI: 10.1177/2399202620947035
Medicine Access @ Point of Care
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