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Annual Reports

Pain Management

Dr. Patricia Morley-Forster
Program Director

Clinical Care

In 2015, there were 1,683 referrals to the SJHC Pain management Program and a total of 6,516 physician visits, and 722 psychology-related visits. We initiated a mandatory Patient Orientation Session for new patients, run weekly by one of the Pain Medicine Residents, Dr. Michael Pariser. This has received very positive feedback, and has led to a reduced "No Show" rate for first-time consults and higher satisfaction with the encounter. 

Clinical staff continued to grow with the addition of Dr. Rachel Reardon from the Department of Physical Medicine and Rehabilitation, and Karen Hobby, a physiotherapist. 

Services offered are: Pain assessment (physical and psychological assessment, identification of successful past treatment modalities, diagnosis, and development of a plan of care based on patient goals); pharmacotherapy, interventional treatments (epidural steroid injections, radio frequency ablation, etc.); intravenous infusions; and individual and group cognitive-behavioural therapy. 

We continue to work on development of care pathways based on evidence-based practices, and discharge planning back to community care. In 2016, we plan to create a transition care pathway from the Pediatric Chronic Pain Program at London Health Sciences Centre to St. Joseph's Adult Pain Management Program. 

Research

Trainee grants up to $10,000 are available annually from the Earl Russell Chair in Pain Management and Research to provide seed funding for pain research projects initiated by trainees registered at Western University or Lawson Health Research Institute. The recipient for 2015 was Dr. Anusha Ratneswaran, a PhD candidate in the Department of Physiology and Pharmacology for a proposal examining pharmacological inhibition of the PPARdelta receptor after induction of osteoarthritis. 

An Interdisciplinary Research Program is led by Dr. Dwight Moulin, the Earl Russell Chair of Research and Education in Pain Management. Further information is available in the Earl Russell Annual Report, available on www.westernpain.ca.

The results of our four year, multi-centre prospective Neuropathic Pain Database were published in September 2015 in the Journal of Pain (Long-Term Outcome of the Management of Chronic Neuropathic Pain: A Prospective Observational Study. Dwight E. Moulin, A. John Clark, Allan Gordon, Mary Lynch, Patricia K. Morley-Forster, Howard Nathan, Cathy Smyth, Cory Toth, Elizabeth VanDenKerkhof, Ammar Gilani, Mark A. Ware). There are now a number of articles in press utilizing data from this registry of almost 800 patients in Canada.

Education 

Undergraduate 

The Meds IV Pain Medicine Selective has been expanded to ten (10) classroom seminars of 1.5 hours each, involving a case-based approach and a mandatory case-based module for Meds IV focusing on chronic low back pain with concurrent addiction. 

Postgraduate

Teaching sessions for the Pain Medicine residents are held every second Wednesday. Within the Western Anesthesia Residency Program, six academic half-days covering a variety of acute, chronic and cancer pain topics were offered to the Senior Resident group.

Two new Pain Medicine residents will be starting first year of the Pain Medicine subspecialty in July, 2016.

Clinical Case Rounds discussing complex cases are held every three months in the Pain Clinic classroom at St. Joseph's Health Care on Wednesday morning from 0715-0815 and are open to all faculty and trainees. 

Continuing Medical Education 

Monthly Interdisciplinary Pain Rounds were arranged again this year by the Earl Russell Chair, Dr. Dwight Moulin. There was a variety of external and local speakers. External speakers this year were Dr. Hance Clarke, Department of Anesthesiology, University of Toronto, Dr. Dean Elterman, Department of Urology, University of Toronto, and Dr. Hans Katzberg, Department of Neurology, University of Toronto. Email notification is circulated to all Department members and they are posted on www.westernpain.ca.

Future Planning

Upon request of the Ministry of Health, a proposal has been submitted for increased staffing to support access to multidisciplinary pain care. The overall goal is to allow the physicians to focus more on the medical aspects of care while the clinical provider team will focus on optimizing the benefits of these treatments through self management and lifestyle behavioural changes.

Another key component of the funding is to provide salary support for a Data Analyst and Quality Evaluation Measurement Consultant. We anticipate funding to be approved as other tertiary Pain Clinics in the province have got their money.