Multidisciplinary team management

See also CfSD Pain Management Consultation Model for Primary Care Health Care Practitioners Sway module

• Consider differential diagnosis (exclude red flags, assess mental health)
• Validate pain and offer support
• Give information – explaining condition, limits of medications (for most people they are ineffective, and for those that do benefit a 30% reduction in pain or a 30% improvement in function is considered effective), self-management
• Consider physio/OT support if difficultly or disruption with daily activities, roles responsibilities

Subsequent appointments will dependent on information obtained during first consultation, but appropriate clinicians may include:

Physio / OT (if available)

• Identify functional deficits and goals
• Rehab approach; education, coping strategies, aids and adaptions, self-management support
• Refer to GP (or ANP) if individual is not progressing, increasing distress, new health issues identified

GP (or ANP)

• Investigating pathology
• Pre contemplative about pain being a long-term condition – ‘wanting a fix’
• Multiple ongoing issues
• High distress
• Consider referral to OT/pharmacist when stable as per inclusion/ exclusion criteria

Pharmacist

• Analgesic polypharmacy high dose opioids, two step 2 opioids
• Medicines management
• Education
• Self-management support
• Refer to GP (or ANP) if individual is not progressing, increasing distress, new health issues identified

See also NHS Lanarkshire animation about their chronic pain service

• Ongoing debilitating pain
• Open to rehabilitation working
• No improvement despite multiple reviews
• Not awaiting other hospital interventions

See also CfSD Sway module Moving from ‘painkillers’ to pain management

• No improvement despite multiple reviews
• Not open to rehabilitation working
• Ongoing distress with pain
• Harmful polypharmacy
• Suspected drug seeking behaviour