The following article is part of conference coverage from the 2019 American Psychiatric Association Annual Meeting (APA 2019) in San Francisco, CA. Psychiatry Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in psychiatry. Check back for the latest news from APA 2019.


SAN FRANCISCO — The implementation of a standardized medication regimen for pain management in incoming psychiatric inpatients may be associated with a reduction in the number of pages related to pain complaints received by on-call residents, according to study results presented at the American Psychiatric Association’s Annual Meeting, held May 18-22, 2019, in San Francisco, California.

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It is thought that the number of pages received by residents may contribute to the burnout they experience, which, in addition to affecting their well-being, may jeopardize patient safety.

The pain management regimen that was examined in the study was initially designed by clinical pharmacists, reviewed by 3 inpatient psychiatric staff providers, and further evaluated by a surgical intensive care unit, internal medicine, and a clinical pharmacist. This regimen consisted of a combination of nonopioid medications for acute pain and was made easily accessible to psychiatry residents for a period of 3 months by being added to the psychiatry order homepage in electronic medical records. Medications were administered by nursing staff, as specified in the instructions. Pain complaints of psychiatric inpatients not admitted on this pre-ordered medication regimen were managed by teams from 2 other staff providers.

During the 3-month study period, 299 patients were evaluated, 206 in the standardized medication regimen group and 93 control participants. A total of 35 pages for pain complaints were received by on-call residents. Of these, only 1 page was from an inpatient treated with the standardized pain management regimen vs 34 from patients in the other group (P =.0001).

“It is unclear if [the reduction in the number of pages for pain to on-call residents upon implementation of this standardized pain management medication order set for initial admission] was due to program efficacy, lack of blinding, or other unidentified variables,“ noted the study investigators.

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Reference

Molick R, Mansfield J, Brown KE, Cupples N. Pain management medication standardization effects on psychiatry resident call burden on a Veterans Affairs inpatient psychiatric unit. Poster presented at: 2019 American Psychiatric Association Annual Meeting; May 18-22, 2019; San Francisco, CA. Abstract 140.