2011 Pain Management Conference - Program Agenda

Download the brochure

Program Agenda:

07:30 – 08:30 Registration and Continental Breakfast

08:30 – 08:40 Welcoming Remarks 

08:40 – 09:25 Improved Opioid Use for Chronic Non-Cancer Pain
  
Andrea Furlan, MD PhD
Staff physician and adjunct scientist at Toronto Rehab, University Health Network; Assistant Professor, Division of Physiatry, Department of Medicine, University of Toronto

This presentation will provide new knowledge and tools via the ‘Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-cancer Pain’ to assist clinicians to safely and effectively use opioids to manage chronic non-cancer pain.

Learning objectives
1. Review the Canadian Opioid Guideline
2.  Become aware of resources to assist clinicians with opioid prescribing
  
09:25 – 10:10 The Acute Care Perspective of Pain Management

Colin J.L. McCartney, MBChB, FRCA, FRCPC
Associate Professor, Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto

After this presentation delegates will understand pain management protocols that can optimize postoperative function and reduce acute and chronic pain after surgery. More specifically delegates will understand how to assess pain, how to transition patients from one route of analgesic administration to another and how to titrate potent pain medications to pain severity.

10:10 – 10:40 Nutrition Break and Exhibit & Poster Viewing

10:40 – 11:25 Workshops (5 concurrent workshops)

Workshop 1: Pharmacological Approaches to Pain

The Use of the Opioid Manager

Andrea Furlan, MD, PhD
Staff physician and adjunct scientist at Toronto Rehab,University Health Network;Assistant Professor, Division of Physiatry, Department of Medicine, University of Toronto

You will become familiar with a tool called Opioid Manager and learn what is important to monitor and document when prescribing opioids for chronic non-cancer pain.

Workshop 2: Clinical Practice Guidelines

Implementation of an Acute Post Operative Interprofessional Clinical Practice Guideline for Musculoskeletal Patients

Mandy McGlynn, BA, BScPT, MSc
Advanced Practice Leader, Toronto Rehab Institute
Musculoskeletal Program & Low tolerance Long Duration Rehab Program,
University Health Network

This session will review the following:
• The best practice framework used for this pain initiative (including identifying pain as an issue, reviewing current practice, determining best practice, gap analysis, preparing for implementation, implementation, evaluation and sustaining)
• Clinical practice guideline evaluation, review & adaptation process
• Review tools for implementation of the guideline including an algorithm for assessment & treatment, patient pain logs, interprofessional tool for documentation of assessment, treatment and reassessment, and patient education materials

Workshop 3: Barriers and Challenges

Proving Chronic Pain: A Lawyer’s Perspective

George O. Frank, B.Math., LL.B
David Derfel, B.A.S.(Hons.), LL.B
David Schell, B.A.(Hons.), LL.B
Devry Smith Frank LLP Lawyers & Mediators

Proving chronic pain claims is difficult given the often vague symptoms and diagnoses associated with it. Those who suffer chronic pain face prejudice and disbelief from those who fail to understand its existence or impact. Court decisions provide an important insight into society’s views and assumptions on chronic pain and its victims. A review of these decisions provides a window into current trends and the future direction of chronic pain claims.

Workshop 4: Self-Management (These workshops have been chosen from the call for abstracts)

A
Goin’ Down the Road: Five Years’ Experience with Y-PEP, a Community-Based Chronic Pain Exercise/Education Self-Management Program

Ruth Dubin, MD, PhD, FCFP
Kingston Family Health Team
St. Mary’s of the Lake Chronic Pain Clinic Assistant Professor, Adjunct, Family Medicine Queen’s University

This presentation will review the program Y-PEP, provide evidence that healthcare utilization can be reduced in attendees, describe one graduate’s case history and discuss program barriers. We will make a case for providing pain education in the community and not the clinic.

B
Differential Effects of a Community-Based Exercise and Self-Management Program in Individuals with High and Low Pain Intensity

Cheryl King-VanVlack
School of Rehabilitation Therapy, Queen’s University

Since 2006, a readily accessible community-based exercise and self-management program (designed by health care professionals and staff at the YMCA) has been offered since access to specialty pain care is limited in the Kingston region. This presentation will focus on the effects of this program on physical function and cognitive outcomes between individuals that initially reported higher versus lower average pain scores. 

Workshop 5: Non-Pharmacological Alternative Therapies

Tai Chi, an Easy Way to Manage the Tough Pain 

Adam Chen, CMD, PhD
Co-director, Acupuncture Clinic at Rehab and Wellbeing Centre, Mount Sinai Hospital

Tai Chi is a meditative slow motion exercise.  Recently, this ancient Chinese martial arts has been turned into a powerful tool for chronic pain management.  The speaker will discuss the theoretical and practical aspects of this “New” therapeutic modality. 

11:25 – 11:35  Transition Time

11:35 – 12:20  The Rehab Care Perspective of Pain Management

John Flannery
Medical Director of the Musculoskeletal Program
Toronto Rehabilitation Institute, University Health Network

The session will focus on the following:
• Recall the best practice approach in pain management in the transition from acute care to rehab
• State the pain evaluation challenges and tools, and pharmacologic and non pharmacologic pain management interventions during rehab and into the community
• Describe the essential collaborative and communication transition processes for managing the patient’s pain in the community

12:20 – 01:15 Networking Lunch and Exhibit & Poster Viewing

01:15 – 02:00 Improving the Transition for People with Pain from Rehab to the Community

Lynn Cooper, BES
President, Canadian Pain Coalition

Individuals living with chronic pain who are fortunate enough to participate in an interdisciplinary rehabilitation program face significant challenges when they return to their “real lives” in the community.  In this session we will explore the challenges for people with pain related to integrating what they have learned into their lives.  As well, we will look at gaps in community systems that may impede the successful carry over of services necessary for maintenance of pain care and functionality.  Further, we will highlight existing community resources that augment transition after rehab and support living well in spite of the pain.   Tying these pieces together we will begin to consider ways to put connections into place to bridge the gap between rehab and community living for the person with pain.
   
02:00 – 02:15    Nutrition Break and Exhibit Viewing

02:15 – 03:00    Workshops – 5 concurrent workshops
   
Workshop 1: Pharmacological Approaches to Pain

An innovative Interprofessional Initiative to Improve Patient Pain Outcomes: Patient-Controlled Oral Analgesia (PCOA): A Randomized Controlled Pilot Study

Patti Kastanias, RN (EC), MSc(A)
Nurse practitioner, Pain Service, Toronto Western Hospital, University Health Network

Patient-controlled oral analgesia (PCOA) is a novel approach to pain management that puts the control of oral medications for postoperative pain in the hands of the patient. Early PCOA studies suggested that the benefits of PCOA were similar to IV PCA, increased patient satisfaction and better pain control.

Workshop 2: Clinical Practice Guidelines

Chronic MSK Pain.... It Takes a Team: Inter-Professional Collaboration across the Care Continuum

Judith Hunter, BSc(PT), MSc, PhD
Assistant Professor, Department of Physical Therapy
University of Alberta and University of Toronto, Curriculum Director, U of A Certificate in Pain Management

Ruth E. Dubin, MD, PhD, FCFP
Kingston Family Health Team, St. Mary’s of the Lake Chronic Pain Clinic,
Assistant Professor, Adjunct, Family Medicine Queen’s University

Paul Taenzer, PhD, RPsych (Alberta)
Adjunct Clinical Assistant Professor, Faculty of Medicine
University of Calgary

We will review the evidence that the best management plan for people with chronic MSK pain requires multi-modal and biopsychosocial approach and therefore interprofessional collaboration.  Then, using a case study of a person with chronic lower back pain, and an example of interprofessional practice guidelines, our audience will participate in defining the barriers and solutions to collaborative practice in Acute and Chronic Care institutions, Community Agencies and primary care.

Workshop 3: Barriers and Challenges

Optimizing Effective Pain Management in the Elderly: Physiologic and Cultural Considerations

Debbie Daly Driver, RN(EC), MN, CRNC, GNC(C)
Nurse Practitioner, Clinic Lead GAIN Geriatric Clinic, The Scarborough Hospital;  Adjunct Lecturer, Lawrence Bloomberg Faculty of Nursing, University of Toronto

Cheryl Bower, RN(EC), MN, GNC(C)
Nurse Practitioner-Adult, Geriatrics Emergency Department
Joseph Brant Memorial Hospital

This presentation will discuss common challenges faced while helping Seniors to manage chronic pain.  This includes physiological considerations of managing pain in the elderly and how to mitigate sociocultural beliefs and influences affecting pain management.

Discussion points will include:
• Understanding differences in physiologic pain perception and presentation in the older person
• Troubleshooting differences in drug absorption, distribution, metabolism and elimination
• Managing age related changes: renal and hepatic function 
• Challenges with cognitive impairment and pain assessment
• Health professionals understanding of pain management and best practices
• Seniors’ beliefs about pain and pain medications
• Cultural considerations
• Overcoming negative past experiences
• Perceived allergies and "I don't like taking pills"

Workshop 4: Guidelines (These workshops have been chosen from the call for abstracts)

A
RNAO Pain Assessment and Management Best Practice Guideline: Implementing Evidence into Clinical Practice in the Inpatient Rehabilitation Program

Anna Kras-Dupuis
St. Joseph’s Health Care London, Parkwood Hospital

This session will describe the implementation process for the Pain Assessment and Management BPG, including:
• Setting the stage (staff awareness, gap analysis)
• Selection of best practice recommendations for implementation
• Education roll-out (content and delivery)
• Process to facilitate consistent pain assessment and monitoring and tools development to support the process
• Pilot and full implementation overview
• Evaluation criteria and results

B
Improving Pain Assessment and Management Through the Implementation of Best Practice Guidelines

Kim Krog, Holland Bloorview Kids Rehabilitation Hospital

The Holland Bloorview Interdisciplinary Pain Committee and the Best Practice Spotlight Organization (BPSO) candidacy team decided to partner to implement the RNAO Best Practice Guideline:  Assessment and Management of Pain. Find out how they implemented it what were the outcomes.

Workshop 5: Non-Pharmacological Alternative Therapies

Neurofunctional Approach: Solving the Acupuncture-Pain Puzzle

Alejandro Elorriaga Claraco, MD, Sports Medicine Specialist (Spain) Director, McMaster University Contemporary Medical Acupuncture Program, Assistant Clinical Professor, Department of Anesthesia, McMaster University

Acupuncture is used widely for pain conditions. Controversy exists regarding best practices and efficacy, as no universal standards are available for practitioners to integrate acupuncture into the treatment of pain problems. A neurofunctional model provides the key for the solution of this puzzle.

03:00 – 03:10 Transition Time 

03:10 – 04:10   Interprofessional Panel Discussion: Pain Management across the Continuum

Moderator:
Nancy Boaro, BScN, MN, CNN(C), CRN(C)
Advanced Practice Leader, Neuro Program
Toronto Rehab, University Health Network

Proposed Panel Members:
Cheryl Bower – Nurse Practitioner, Long Term Care and Community Perspective
Debbie Driver – Nurse Practitioner, Acute Care and Community Clinic Perspective
Ruth Vallis – Physiotherapist, Rehab Perspective
Anita Srivastava – Family Physician Perspective

In this interactive session, panelists will discuss a case scenario that addresses a broad range of issues associated with pain management across the continuum of care. The panel will invite audience participation as it explores the challenges and suggests interventional approaches that may be used to facilitate patient goals. Bring your questions from the case material for this session, which you will receive during the day, and from your real-life experience.

04:10 – 04:15    Closing Remarks and Poster Awards Ceremony


Thank you to our platinum sponsor




Thank you to our sapphire sponsor