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VHA Pain Management

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Resources

Explore useful pain management information, to include pain education and pain management resources. This website facilitates effective pain management by providing convenient, centralized access to resources for the provision of pain services within the VA healthcare system.

Educational Resources for Providers:
Chronic Pain Primer:  A brief introductory text that provides basic information regarding chronic pain and multidisciplinary treatment.
•COPE-REMS  - a free online course designed to educate healthcare providers on how to more safely and effectively utilize opioid therapy to treat patients with chronic pain. Find out more, go to go to their website: www.COPEREMS.org *

Clinical Tools
Assessment Resources

  • Assessing Pain in the Patient with Impaired Communication.  The consensus statement from the VHA National Pain Management Strategy Coordinating Committee.
  • CPRS Pain Assessment and Reassessment Template is available from your facility Clinical Applications Coordinator.  There are a growing number of users in VHA.  It is explicitly recommended for adoption in the soon-to-be-released VHA Pain Management Directive that strongly recommends the use of a standardized tool for pain assessment beyond pain screening with the 010 pain numeric rating scale. This link is a Word document that was developed as an educational resource.
  • The International Classification of Headache Disorders * The 2nd edition of the hierarchical nosology designed for both clinical practice and research.
  • The VHA Pain Outcomes Toolkit [revised February 2003] is designed to assist healthcare providers and facilities to devise methods and implement processes to measure pain treatment outcomes.

Pain Measures
- Pain Drawing. This simple version of the Pain Drawing Scale may be used by patients to indicate the location and quality of their pain conditions.
- Pain Numeric Rating Scale (NRS) -  This version of the Pain NRS assesses current, usual, least, and worst pain intensity on a 0 to 10 scale.
- Defense and Veterans Pain Rating Scale (DVPRS) Complete Assessment – A 5-item instrument to assess a patient’s pain experience, including pain intensity and the biopsychosocial impact of pain (influence on activity, sleep, mood, and level of stress) - DVPRS Graphic - DVPRS Assessment .
- Pain Outcomes Questionnaire -  The POQ is an outcomes package consisting of intake, post-treatment, and follow-up questionnaires that was developed to assess several key domains of pain treatment outcomes. The POQ contains six core subscales that assess pain intensity, pain-interference in an activities of daily living (ADLs) and mobility, negative affect, activity diminishment, and pain related fear. To obtain a copy of the questionnaire, please send an email to - Evangelia.Banou@va.gov.  
- West Haven-Yale Multidimensional Pain Inventory.  The West Haven-Yale Multidimensional Pain Inventory (WHYMPI/MPI) is a brief, psychometrically-sound measure of several important aspects of the chronic pain experience. 

Clinical Practice Guidelines
•VA/DoD Clinical Practice Guideline
- Management of Opioid Therapy for Chronic Pain
•CDC Guideline
- Prescribing Opioids for Chronic Pain*

AHRQ Evidence-based Practice Guidelines
- National Center for Biotechnology Information Books: Chronic Pain *

•National Comprehensive Cancer Network Guidelines
- Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society *
- APS & AAPM Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain *

Links to Other Clinical Resources/Professional Societies
-
Chronic Pain Rehabilitation Program * The Chronic Pain Rehabilitation Program (CPRP) is an award-winning, comprehensive, inpatient pain treatment program established in 1988 to help veterans with chronic pain cope with their conditions. National referrals welcome. For more information on the CPRP and referrals please visit: http://www.tampa.va.gov/services/Chronic_Pain_Rehabilitation_Program.asp
- American Chronic Pain Association * The American Chronic Pain Association (ACPA) is a non-profit, tax exempt organization providing a support system for those suffering with chronic pain through education and self-help group activities.
- City of Hope Palliative Care Resource Web Site * This web page contains a collection of links to a broad range of resources for the assessment and treatment of pain. Although the primary focus of the site is palliative care, it provides a significant number of links to general pain management resources.
- National Headache Foundation * The National Headache Foundation is a non-profit organization dedicated to educating headache sufferers and healthcare professionals about headache causes and treatments.
- American Academy of Hospice and Palliative Medicine * AAHPM is an organization of physicians and other medical professionals dedicated to excellence in and advancement of palliative medicine through prevention and relief of patient and family suffering by providing education and clinical practice standards, fostering research, facilitating personal and professional development, and by public policy advocacy.
- Amercian Academy of Pain Medicine * AAPM is the medical specialty society representing physicians practicing in the field of Pain Medicine.
- American Headache Society * AHS is a professional society of health care providers dedicated to the study and treatment of headache and face pain.
- American Pain Society * APS is a multidisciplinary educational and scientific organization dedicated to serving people in pain.
- American Society of Pain Management Nursing * ASPMN is an organization of professional nurses dedicated to promoting and providing optimal care of individuals with pain, including the management of its sequelae.
- American Society of Regional Anesthesia and Pain Medicine * ASRAPM clinical and professional educational needs of physicians and scientists, strives for excellence in patient care utilizing regional anesthesia and pain medicine, and investigates the scientific basis of the specialty.
- International Association for the Study of Pain * IASP is a leading professional forum for science, practice, and education in the field of pain.
- Pain Action * -  http://www.painaction.com/
- Pain EDU * -  http://www.painedu.org/
- Chronic Pain * -  http://www.chronicpain.org/
- American Pain Foundation * -  http://www.painfoundation.org/
- Pain Medicine *   http://www.painmedicinenews.com/ 

Administrative Resources
•Pain Policy:
- James A. Haley (Tampa) VA Chronic Pain Rehabilitation Program Policy. An example of a Hospital Policy Memorandum outlining the purpose and scope of an interdisciplinary program. 
- VHA Pain Management Strategy Overview. A detailed overview of the VHA Pain Management Strategy
- VHA National Pain Management Strategy: Update and Future Directions. A presentation by the Program Director for VA National Pain Management

All the links marked with asterisk ( * ) are External links. By clicking on these links, you will leave the Department of Veterans Affairs Website. VA does not endorse and is not responsible for the content of the linked website.