Columbia VAHCS’s Dr. Brandon Brooks Champions Personalized Pain Management in Limb Salvage Surgery
Dr. Brandon Brooks, a staff podiatrist at the Columbia VA Health Care System (VAHCS), has emerged as a trailblazer in the field of podiatric medicine. His groundbreaking research project, titled "Opioid Prescribing Approaches in Limb Salvage Surgery," earned him first place at the American Podiatric Medical Association's Annual Scientific Meeting, July 16.
Dr. Brooks' study sheds light on the benefits of tailored postoperative pain management plans, emphasizing the importance of considering individual patients' opioid histories, particularly among Veterans.
Brooks' research underscores the significance of personalized pain management strategies for patients undergoing limb salvage surgery, procedures that aim to prevent a major amputation in individuals with limb-threatening conditions.
“The Columbia VAHCS is very grateful, and lucky to have a staff physician as dedicated and forward thinking as Dr. Brooks,” said Columbia VAHCS Director/CEO, John Merkle. “Thanks to devoted professionals like Dr. Brooks our Veterans can rest assured that they will be taken care of in a thoughtful manner.”
When asked the inspiration behind his research project, Brooks stated: “The United States’ opioid epidemic is still a serious public health crisis. Even though fentanyl is a huge problem, prescription opioids still contribute. It’s also personal for me because my younger sister Britney passed away from an opioid-overdose about 6 years ago. Many Americans have lost loved ones or know of someone who has.”
By acknowledging diverse opioid histories, Brooks' research advocates for adopting customized pain management plans that consider individual patient needs, optimizing pain relief while minimizing the risks associated with opioid misuse, dependency, and addiction.
Brooks' study reveals numerous advantages associated with personalized pain management plans. Firstly, clinicians can effectively address pain without resorting to excessive opioid prescriptions by tailoring postoperative pain medication to each patient's specific requirements. This approach reduces the potential for over-prescribing and the associated risks of opioid misuse and addiction.
Secondly, customized plans account for individual tolerance levels, ensuring that patients receive adequate pain relief while minimizing adverse effects such as sedation, respiratory depression, and gastrointestinal complications. By carefully assessing a patient's opioid history, medical professionals can tailor pain management strategies that strike an optimal balance between effective pain relief and the avoidance of unnecessary complications.
Thirdly, personalized plans take into account the potential for long-term opioid use. Veterans with a history of chronic pain or prior opioid dependency require specialized approaches to prevent relapse and promote recovery. Dr. Brooks' research stresses the importance of transitional care, ensuring that veterans receive the necessary support and alternative pain management strategies as they move beyond limb salvage surgery.
“I was interested in comparing the quantities of postoperative opioids among two groups: (1) podiatrists that use a single quantity for all their surgeries and (2) podiatrists that change their quantity based on their patient and procedure,” said Brooks. “Podiatrists who utilized ‘one size fits all’ opioid prescribing approach reported prescribing more postoperative opioid dosage units regardless of the surgery; however, this difference was magnified with the relatively ‘minor’” procedures. Podiatrists that used a ‘patient-centric and procedure-focused approach reported prescribing significantly fewer opioid dosage units for [minor procedures].”
Brooks' research findings have significant implications for both patient outcomes and safety. By adopting tailored pain management plans, healthcare providers can enhance patient satisfaction and overall recovery experiences. By considering Veterans' specific opioid histories, clinicians can minimize adverse events, reduce the risk of opioid-related complications, and improve long-term patient outcomes.
“I think that this study shines a light on the need to shift from a standardized postoperative approach to a more customized pain management plan. Many factors can contribute to a patient’s postoperative pain. It is pertinent for all clinicians to understand a Veteran’s opioid history (i.e., opioid-naïve, occasional use, daily use/tolerant) and medical comorbidities in order to craft a customized postoperative pain management plan,” said Brooks. “Ultimately, I believe that a ‘patient-centric and procedure-focused’ prescribing approach is suited to limit excess prescribing while protecting the provider-patient relationship and not forcing further regulatory burden onto clinicians.”
Furthermore, Dr. Brooks' study aligns with a broader effort to address the ongoing opioid crisis in the United States. By advocating for customized postoperative pain management plans, healthcare providers can contribute to reducing opioid overuse and abuse, mitigating the societal impact of opioid addiction and related consequences.
Brooks added: “We can all make a difference by reminding our patients to properly dispose of unused opioid pain medication. It is estimated that over half of opioid misusers last obtained opioids from a friend or relative. Finally, I really appreciate the work of the Dorn VA research committee, the Institutional Review Boards, and Dr. Ryan (Columbia VAHCS Associate Chief of Staff - Research); everyone is very encouraging and constructive when writing proposals. Dorn is a great place for researchers!”
For more information about what’s going on at the Veterans medical center, clinic locations and other services available to Veterans in and around Columbia, visit the website https://www.va.gov/columbia-south-carolina-health-care/ and follow us on Facebook, Twitter and Instagram, keyword: VAColumbiaSC.