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The gertrude levin pain clinic — Challenges and discoveries in development of a multidisciplinary clinic for the management of chronic pain
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THE GERTRUDELEVIN PAIN CLINIC - CHALLENGESAND DISCOVERIES ----36}-Pc .... i IN DEVELOPMENTOF A MULTIDISCIPLINARY CLINIC FOR THE ~NAGEMENT OF CHRONIC PAIN. John R. F. I n q a l l , M.D., Associate Frldoy Medical Director, Michigan Cancer Foundation; Director, i Gertrude Levin Pain C l i n i c , Wayne State University, Detroit MI 48201, USA Aim of Project: To develop a m u l t i d i s c i p l i n a r y pain c l i n i c with a diagnostic screening regimen as a prime feature. To demonstrate the management and cost advantages of pre-encounter analysis of patient data and the singular contribution of the c l i n i c a l pharmacist and psychologist to the design of the c l i n i c a l management. Methods: A d i s c i p l i n e of referral was established as a condition for admission to the Gertrude Levin Pain Clinic. All patients were assessed by a c l i n i c a l pharmacist and psychologist p r i o r to examination by the Pain Team - surgeon, neurologist, anesthesiologist, p h y s i a t r i s t , and special consultants as scheduled. Follow-up was established to categorize outcome. Results: A significant excess of medication, prescription and nonprescription drugs was found. Drugs with opposing activities were found. Pain r e l i e f was obtained by the use of t r i c y c l i c antidepressants in preference to analgesics. Time spent with the patient was an index of satisfaction. Conclusions: The construction of a group report and follow-through to the referring physician can be achieved on one encounter. The role of the clinical pharmacist is vital in the analysis of the chronic pain patient and recommendations of pharmacological options in management. The clinical screening by the psychologist provides major assistance in assessing the personality of the patient and the pertinence of wellestablished techniques in psychological management. Team assessment and composite management designs are organizationally possible, economically feasible, and provide a balanced opinion. 368 Pc DHMONSTRATION OF THE USE OF A MICRO-COMPUTER ~N A PAIN I RELIEF CLINIC. G.R. Gersonl~ & J.N. Gerson'~'_Pain ClinicJ Fridoy Royal Sussex County Hospi%al, Brighton College ~' Brighton, I Sussex, England. Aim of Pro~ect A large amount of clinical data is obtained in a Pain Clinic but this information is not readily accessible. It was decided to convert an existing punch card system into a computer controlled data storage and retrieval system to facilitate the speedy recovery of data and also achieve its analysis and correlation by means of logical functions Methods A Commodore PET 2OO1 microcomputer with 2040 dual drive floppy disk unit was used. A system of programs was written in BASIC language to produce results isomorphic to those provided by the old punch card system but more efficiently and faster and with some additional functions. Existing data was manually transfered from the cards to the computer. Results The following results are demonstrated on the screen of the PET and on a:larger screen: 1. Data from any single patient. 2. Correlated Data from approximately 1CO0 Pain Clinic patients. 3. Tables relating to the correlated Data. 4. A method for measuring pain using the computer. Conclusions A microcomputer makes information accessible to a clinician quickly and cheaply. The analysis of correlated data will prove valuable in trend recognition and subsequent patient management.
THE GERTRUDELEVIN PAIN CLINIC - CHALLENGESAND DISCOVERIES ----36}-Pc .... i IN DEVELOPMENTOF A MULTIDISCIPLINARY CLINIC FOR THE ~NAGEMENT OF CHRONIC PAIN. John R. F. I n q a l l , M.D., Associate Frldoy Medical Director, Michigan Cancer Foundation; Director, i Gertrude Levin Pain C l i n i c , Wayne State University, Detroit MI 48201, USA Aim of Project: To develop a m u l t i d i s c i p l i n a r y pain c l i n i c with a diagnostic screening regimen as a prime feature. To demonstrate the management and cost advantages of pre-encounter analysis of patient data and the singular contribution of the c l i n i c a l pharmacist and psychologist to the design of the c l i n i c a l management. Methods: A d i s c i p l i n e of referral was established as a condition for admission to the Gertrude Levin Pain Clinic. All patients were assessed by a c l i n i c a l pharmacist and psychologist p r i o r to examination by the Pain Team - surgeon, neurologist, anesthesiologist, p h y s i a t r i s t , and special consultants as scheduled. Follow-up was established to categorize outcome. Results: A significant excess of medication, prescription and nonprescription drugs was found. Drugs with opposing activities were found. Pain r e l i e f was obtained by the use of t r i c y c l i c antidepressants in preference to analgesics. Time spent with the patient was an index of satisfaction. Conclusions: The construction of a group report and follow-through to the referring physician can be achieved on one encounter. The role of the clinical pharmacist is vital in the analysis of the chronic pain patient and recommendations of pharmacological options in management. The clinical screening by the psychologist provides major assistance in assessing the personality of the patient and the pertinence of wellestablished techniques in psychological management. Team assessment and composite management designs are organizationally possible, economically feasible, and provide a balanced opinion. 368 Pc DHMONSTRATION OF THE USE OF A MICRO-COMPUTER ~N A PAIN I RELIEF CLINIC. G.R. Gersonl~ & J.N. Gerson'~'_Pain ClinicJ Fridoy Royal Sussex County Hospi%al, Brighton College ~' Brighton, I Sussex, England. Aim of Pro~ect A large amount of clinical data is obtained in a Pain Clinic but this information is not readily accessible. It was decided to convert an existing punch card system into a computer controlled data storage and retrieval system to facilitate the speedy recovery of data and also achieve its analysis and correlation by means of logical functions Methods A Commodore PET 2OO1 microcomputer with 2040 dual drive floppy disk unit was used. A system of programs was written in BASIC language to produce results isomorphic to those provided by the old punch card system but more efficiently and faster and with some additional functions. Existing data was manually transfered from the cards to the computer. Results The following results are demonstrated on the screen of the PET and on a:larger screen: 1. Data from any single patient. 2. Correlated Data from approximately 1CO0 Pain Clinic patients. 3. Tables relating to the correlated Data. 4. A method for measuring pain using the computer. Conclusions A microcomputer makes information accessible to a clinician quickly and cheaply. The analysis of correlated data will prove valuable in trend recognition and subsequent patient management.