Pain: ‘the next 11 months are critical’


The Perth leg of the PainWISE tour

The lead-up to the codeine upschedule is a critical time for pharmacy, an expert says amid the launch of a new pain professional service

Clinical pharmacist Joyce McSwan, pain educator and Persistent Pain Program manager at the Gold Coast Primary Health Network, was launching her PainWISE initiative this week when the news came that MedsASSIST would be terminated. The MedsASSIST shutdown is currently on hold after intervention from the Health Minister.

PainWISE is a community-based pharmacy professional service program aimed at helping people with chronic pain manage their condition.

“We need to think beyond temporary ‘knee jerk’ moves and consider longer term impacts of such cancellations of monitoring programs, whether the benefit is for a more a few more months or for years to come,” Ms McSwan told the AJP.

“These next 11 months are critical and I certainly think that monitoring until the 1st February at the very least would be very beneficial.  

“Upscheduling codeine will bring about its own changes in the way prescriptions are managed from the GP and persons suffering pain, which remain unknown to all of us. I would hope that the investment already in an excellent software like MedsASSIST could be modified to something that would continue to help the second wave of what we will see post codeine upscheduling.”

She says that the escalation of opioid use, “a medicalised issue, of which we are all have a part to play”, requires monitoring one way or another.”

The Pharmacy Guild and other stakeholders have repeatedly called for the introduction of a national, real time monitoring program for prescription painkillers and other controlled drugs.

Ms McSwan welcomed the Health Minister’s intervention on MedsASSIST.

“I am grateful he understands the greater impact on the health system. I think the pharmacy profession has been through a lot and any sudden moves one way or another is not helpful for the confidence of pharmacists, their patients and the greater medical profession.

“Pharmacy is part of the ecosystem of healthcare (as is every other healthcare professional) and any contributions positively and negatively has impacts on the overall health system, most of all the impact on the patient.”

When the announcement was made on Wednesday that MedsASSIST would be wound up, Ms McSwan was in Perth for the beginning of the PainWISE national tour.

“We spent a day gearing up for the changes in codeine upscheduling and there were empowered pharmacists leaving keen to get back to supporting their local communities with new tools, resource and skills to manage pain better that I have created for them to use. 

“Despite the release of news yesterday about the changes in MedsAssist, it was timely to debrief with the Perth pharmacists at the time.

“What was very encouraging was because the pharmacist felt empowered by the strategies PainWISE was providing for them, they did not feel too disabled without the MedsAssist tool, they were keen and ready nevertheless to support those suffering pain, those dependent on wrong types of pain relievers and were better equipped to navigate to better services and evidence based products.”

Ms McSwan says that to date, there have been significant gaps in the pain management area.

“One of the missing links to all of this is a major lack of understanding of where the science of pain truly is and how this integrates into policy making. That is where the wheels are falling off.”

PainWISE is supported by Pain Australia.

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