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Pain Treatment - Position/Policy/Consensus Statements

The following documents are organized in logical clinical categories, beginning with the most recently published, updated, or reviewed paper in each category. Most links provide the full statement in html text or a PDF; a reference citation or abstract is linked when the full-text is unavailable.

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Document Researchers: Winnie Dawson, MA, RN, BSN; Stewart B. Leavitt, MA, PhD

= entry added or changed during latest update.

CONTENTS

• General Pain & Safety Topics
• Acute Pain
• Cancer Pain
• Cardiac & Chest Pain
• Chronic & Intractable Pain
• Geriatric Pain
• Gynecological or Obstetrical Pain
• Headache
• Musculoskeletal Pain  (including Arthritis and Fibromyalgia)
• Neuropathic Pain
• Non-Opioid & Complementary Therapies  ...also see documents in Non-Opioid Therapies tab section
• Opioid Therapy & Safety  ...also see documents in Opioid Rx tab section
• Pain in Palliative Care
• Pediatric Pain
• Perioperative Pain

General Pain & Safety Topics

Pain Assessment in the Patient Unable to Self-Report: Position Statement with Clinical Practice Recommendations

From: Herr K, Coyne PJ, McCaffery M, et al. Pain Management Nursing. 2011;12(4):230-250.
This 25-page paper, plus extensive tables and references, replaces an earlier document of the same title from 2006. It defines populations at risk and offers clinical practice recommendations for pain assessment in those unable to self-report, including children and adults with cognitive impairments or other conditions limiting verbal communication. Access checked January 28, 2012. See PDF document>

The University of Wisconsin Pain & Policy Study Group – Database and Reports

Database of State Laws, Regulations and Other Official Governmental Policies (includes guidelines and policy statements) — Updated quarterly. Accessed March 26, 2012. See database...>
 

The following two documents are being updated and expected to be reissued in 2013:
Achieving Balance in Federal and State Pain Policy: A Guide to Evaluation (a report on federal and state policies that may enhance or impede pain management) — July 2007.
Achieving Balance in Federal and State Pain Policy: A Progress Report Card (this publication reviews each state’s progress as it compares to the ‘Central Principal of Balance’ which relates to the balance of medical availability and drug control) — July 2007.

The University of Wisconsin Pain & Policy Study Group is a collaborative group of practitioners and researchers from varied environments in universities, government agencies and professional organizations. Their stated mission is to “balance international, national and state policies to ensure adequate availability of pain medications for patient care while minimizing diversion and abuse, and to support a global communications program to improve access to information about pain relief, palliative care, and policy” and their website can be accessed at: http://www.painpolicy.wisc.edu/

ASPMN position statement: registered nurse management and monitoring of analgesia by catheter techniques

American Society for Pain Management Nursing. 2007(Jun). Accessed March 4, 2009. See text PDF...>

Dispensing controlled substances for the treatment of pain

Drug Enforcement Administration, Office of Diversion Control. 2006(Sep). Accessed March 4, 2009. See text ...>

Authorized and unauthorized (“PCA by Proxy”) dosing of analgesic infusion pumps

American Society for Pain Management Nursing. 2007(Mar). Accessed March 4, 2009. See text PDF...>

Position statement on use of placebos in pain management

American Society of Pain Management Nurses. 2004(Jul). Accessed March 4, 2009 See text PDF...>

ASPMN position statement on pain management in patients with addictive disease

American Society for Pain Management Nursing. 2002(Sep). Accessed March 4, 2009. See text PDF...>

Promoting pain relief and preventing abuse of pain medications: a critical balancing act

A joint statement from 21 health organizations and the Drug Enforcement Administration. 2001(Oct). Accessed March 4, 2009. See text PDF...>

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Acute Pain

Procedural Pain Management: A Position Statement with Clinical Practice Recommendations

From: American Society for Pain Management Nursing (ASPMN), 2011.
This 17-page document discusses ethical and cultural considerations, analgesic agents in different age groups, patient care, and interventions for patient education and nonpharmacologic comfort and support. Access checked September 17, 2011. See PDF document>

Procedural Sedation in Emergency Care Settings Consensus Statement

American Society of Pain Management Nursing plus 7 other professional organizations. 2008. Accessed March 4, 2009. See text PDF...>

The use of "as-needed" range orders for opioid analgesics in the management of acute pain

A consensus statement of the American Society of Pain Management Nurses and the American Pain Society. Approved 2001, revised and updated 2004. Accessed March 4, 2009. See text PDF...>

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Cancer Pain

Symptom management in cancer: pain, depression and fatigue

NIH Consensus Development Program. 2002(Jul). Accessed March 4, 2009. See text ...>

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Cardiac & Chest Pain

None in this category at present.

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Chronic & Intractable Pain

Pain management for persons living with HIV/AIDS

Association of Nurses in Aids Care Position Statement. Adopted 2005, reviewed and revised 2009. Accessed March 4, 2009. See text PDF...>

Pain assessment and treatment in the managed care environment

American Pain Society. Approved 2000, reviewed and updated 2006. Accessed March 4, 2009. See text PDF...>

Recommendations for the appropriate use of opioids for persistent non-cancer pain

A consensus statement prepared on behalf of the British Pain Society, the Royal College of Anaesthetists, the Royal College of General Practitioners, and the Royal College of Psychiatrists. 2004(Mar). Accessed March 4, 2009. See text PDF...>

Treatment of pain in chronic pancreatitis

American Gastroenterological Association. 1998(Apr);115:763-764. Accessed March 4, 2009. See text PDF...>

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Geriatric Pain

Opioids and the management of chronic severe pain in the elderly...

... consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone)

Johns Hopkins University. 2008. Accessed December 13, 2010. See summary text...>

Statement on pain recognition and assessment in older adults

American Society of Consultant Pharmacists. 2002 (Jul). Accessed March 4, 2009. See text PDF...>

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Gynecological or Obstetrical Pain

Summary consensus statement: diagnosis and management of chronic prostatitis/chronic pelvic pain syndrome

Reported in European Urology Supplements. 2003(Mar). Accessed March 4, 2009. See text PDF...>

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Headache

Migraine prevention consensus statement

National Headache Foundation. 2007(Jan). Accessed March 4, 2009. See text...>

Sinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment

Cady RK, et al. Mayo Clinic Proceedings. 2005;80(7)908-916. Accessed March 4, 2009. See text PDF...>

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Musculoskeletal Pain (including Arthritis and Fibromyalgia)

Joint Position Statement: Updated ACOEM Chronic Pain and Low Back Guidelines

National Pain Foundation, American Academy of Pain Medicine, American Pain Foundation, American Society of Interventional Pain Physicians, International Spine Intervention Society, Neuromodulation Therapy Access Coalition, and the North American Neuromodulation Society. 2008(May). Accessed May 16, 2009. See text PDF...>

Arthritis Foundation statement on chondroitin and pain relief

Arthritis Foundation. 2007(Apr). Accessed March 4, 2009. See text PDF...>

Arthritis Foundation statement on rituximab for rheumatoid arthritis

Arthritis Foundation. 2006(Mar). Accessed March 4, 2009. See text PDF...>

Arthritis Foundation statement on the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT)

Arthritis Foundation. 2006(Feb). Accessed March 4, 2009. See text PDF...>

Primary care interventions to prevent low back pain in adults: recommendation statement

U.S. Preventive Services Task Force. 2004(Feb). Accessed March 4, 2009. See text PDF...>

Arthritis Foundation statement on hyaluronic acid treatment for osteoarthritis of the knee

Arthritis Foundation. 2004(Jan). Accessed March 4, 2009. See text...>

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Neuropathic Pain

Position statement on spinal cord neurostimulation [for chronic neuropathic pain]

American Academy of Pain Medicine, American Society of Interventional Pain Physicians, International Spine Intervention Society, Neuromodulation Therapy Access Coalition, and the North American Neuromodulation Society. 2008(June).

This consensus statement provides a very basic review of the indications and efficacy of spinal cord stimulation (SCS) as a minimally invasive treatment for chronic intractable neuropathic pain. Participant researchers and experts stress the potential value of SCS in pain relief and improved functionality for appropriate patients who have not experienced success with other forms of treatment. Accessed March 4, 2009. See text PDF...>

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Non-Opioid & Complementary Therapies  ...also see Non-Opioid Therapies tab section

None in this category at present.

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Opioid Therapy & Safety  ...also see Opioid Rx tab section

Model policy for the use of controlled substances for the treatment of pain

Federation of State Medical Boards. 2004(May). Accessed March 4, 2009. See text PDF...>

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Pain in Palliative Care

Providing opioids at the end of life

Hospice and Palliative Nurses Association. 2004(Apr). Accessed March 4, 2009. See text...>

ASPMN position statement on pain management at the end of life

American Society of Pain Management Nurses. 2003. Accessed March 4, 2009. See text PDF...>

Undergraduate medical education on pain management, end-of-life care, and palliative care

American Academy of Pain Medicine. 2000(Jul). Accessed March 4, 2009. See text PDF...>

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Pediatric Pain

Prevention and management of pain in the neonate: an update

American Academy of Pediatrics, Committee on Fetus and Newborn and Section on Surgery, Canadian Pediatric Society and Fetus and Newborn Committee. 2006(Nov);118(5):2231-2241. Accessed March 4, 2009.

See text PDF...>

The assessment and management of acute pain in infants, children, and adolescents

American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health and American Pain Society Task Force on Pain in Infants, Children, and Adolescents. Approved 2001, reviewed and updated 2006. Accessed March 4, 2009. See text...>

Consensus statement for the prevention and management of pain in the newborn

International Evidence-Based Group for Neonatal Pain. 2001. Accessed March 4, 2009. See text PDF...>

ASPMN position statement on neonatal circumcision pain relief

American Society of Pain Management Nurses. 2001(Oct). Accessed March 4, 2009. See text PDF...>

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Perioperative Pain

None in this category at present.

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