Guidelines

Pain and Symptom Management

Note: Some of the following are only available for purchase through the sponsoring organizations.

Guidelines For The Use Of Controlled Substances For The Treatment Of Pain http://Pr.Mo.Gov/Boards/Healingarts/Csguide.pdf
The Missouri State Board of Registration for the Healing Arts developed these guidelines to clarify the Board's concerns on pain control, particularly as they related to the use of controlled substances, to alleviate physician uncertainty and to encourage better pain management.

Palliative Care Guidelines
http://Pr.Mo.Gov/Boards/Healingarts/Heapalliativecareguidelines.pdf
The Missouri State Board of Registration for the Healing Arts position is that physicians who care for terminally ill patients should be knowledgeable about palliative care. These guidelines assist those physicians in treating terminally ill patients.

"The Management of Persistent Pain in Older Persons." Clinical Practice Guideline, 50 (June 2002): 6. American Geriatrics Society. www.americangeriatrics.org/products/positionpapers/JGS5071.pdf

Principles of Analgesic Use in the Treatment of Acute Pain and Cancer Pain, Fifth Edition, 2003,
www.ampainsoc.org/pub/principles.htm

Packed with a wealth of updated information in an easy-to-use format, the American Pain Society's Principles of Analgesic Use in the Treatment of Acute Pain and Cancer Pain, Fifth Edition , offers concise information about appropriate drug selection, dosing variation among patient populations, rapid treatment of breakthrough pain, and side effect minimization. This popular reference is the perfect resource for teaching medical and nursing students.

Model Policy for the Use of Controlled Substances for the Treatment of Pain,
http://www.fsmb.org/pdf/2004_grpol_Controlled_Substances.pdf
The Federation of State Medical Boards of the United States (FSMB) model policy is a revision of a set of guidelines developed by the FSMB in 1998.
The new policy:

• recognizes the inadequate management of pain and barriers to appropriate treatment;
• emphasizes the dual obligation of government to develop a system that prevents abuse, trafficking and diversion of controlled substances while ensuring their availability for legitimate medical purposes;
• revises definitions of addiction, chronic pain and physical dependence to reflect current consensus and expertise in the medical community; and
• updates criteria for evaluating the appropriate management of pain

Guideline for the Management of Pain in Osteoarthritis, Rheumatoid Arthritis, and Juvenile Chronic Arthritis, 2nd Edition, American Pain Society Clinical Practice Guideline, 2002.
www.ampainsoc.org/pub/arthritis.htm

This clinical guideline targets treating acute and chronic pain associated with arthritis, a chronic disease that afflicts one in six Americans. The guideline strongly emphasizes that arthritis pain is best treated through a combination of ongoing pain assessment, medication, proper nutrition, exercise and patient and family education.

Developed by a panel of experts in arthritis pain management, the guideline for is the first multidisciplinary, evidence-based clinical guideline for treatment of arthritis pain. It is intended for use by physicians, nurses and other healthcare professionals who treat adults and children with arthritis.

Guideline for the Management of Acute and Chronic Pain in Sickle Cell Disease, American Pain Society Clinical Practice Guideline, 1999.
www.ampainsoc.org/pub/sc.htm

This guideline is to aid physicians, nurses, pharmacists, and other healthcare professionals in managing acute and chronic pain associated with sickle-cell disease.

A multidisciplinary panel of experts developed the guideline using the best available scientific evidence to make recommendations that can aid healthcare professionals in managing pain associated with sickle-cell disease. It makes clear that one of the most important steps toward improving pain control in sickle cell disease is education. Patients and families need to understand more clearly sickle-cell disease and pain management. Moreover, support is needed for patient/families in coping with the realities of sickle-cell disease. Another very important point stressed in the guidelines is the need for frequent assessments by healthcare professionals to maintain pain control, adjust appropriately for changes in medication effectiveness and/or adverse effects.

Chronic pain management in the long-term care setting. American Medical Directors Association - Professional Association. 1999. www.amda.com/info/cpg/chronicpain.htm

This guideline outlines many of the myths and misperceptions about pain caused by nonmalignant conditions and the barriers to effective pain management and offers steps for overcoming these barriers.

The revised guideline now has an acute pain component to address the CMS quality initiative measure for pain. It also includes an expanded section on recognizing pain in the cognitively impaired, an expanded section on pain management in palliative care, updated pharmacology, an expanded section on alternative therapies, a more appropriate way of measuring pain management for residents who either don't ask for pain medication or for those who most likely are controlled but will still claim to be in pain. The guideline is directed toward the entire interdisciplinary team--as well as patients and their families--in order to achieve effective pain management.

Monograph 1: Pain: Current Understanding of Assessment, Management and Treatments, www.npcnow.org/resources/PDFs/painmonograph.pdf

This monograph was produced under a collaborative project between the Joint Commission on Accreditation of Healthcare Organizations and the National Pharmaceutical Council, Inc.

It has two primary objectives.

1. To provide practical knowledge that will enhance the reader's understanding and management of pain.
2. To introduce some strategies to improve pain management.

Monograph 2: Improving the Quality of Pain Management Through Measurement and Action, www.npcnow.org/resources/PDFs/PainMonograph2.pdf

This monograph was written for clinicians, pain management teams, quality improvement professionals, researchers, and others involved in pain management performance assessment, improvement, education, and policy-making. It is intended for use in conjunction with the companion monograph Pain: Current Understanding of Assessment, Management, and Treatments, which focuses on the etiology, physiology, and clinical treatment of pain.

It was produced under a collaborative project between the Joint Commission on Accreditation of Healthcare Organizations and the National Pharmaceutical Council, Inc.

National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines: Adult Cancer Pain, 2007.

National Guideline Clearinghouse
The National Guideline Clearinghouse™ (NGC), is a public resource for evidence-based clinical practice guidelines. NGC is an initiative of the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services.