Page 61 - Retail Pharmacy Assistants September 2020

By Nerine Zoio.
Paediatric pain is a big issue in Australia, with many skilled healthcare professionals not understanding this niche area and not enough paediatric pain clinics available.
This is according to Painaustralia CEO Carol Bennett, who says a young woman from Canberra recently attended one of the organisation’s forums and recounted how she had to regularly visit Sydney’s pain clinics as a child to receive proper treatment for her debilitating pain.
She adds that children usually experience pain in the form of headaches, abdominal pain, nerve pain and limb pain, but that it can be difficult for pharmacists and parents to recognise and locate their pain.
What can make it more confusing is that children in pain may not be able to pinpoint the source of their pain accurately or describe it.
Regardless of whether parents know exactly the source of their children’s pain or where it is located, their first port of call is the local pharmacy.
This is true to the extent that another pharmacist in Melbourne, who wishes to remain anonymous, says the pharmacy is now dispensing children’s painkillers, such as paracetamol, behind the counter because so many parents are amassing these medications.
Ms Bennett from Painaustralia says, one way or another, children’s pain must be treated, because if left untreated, it could have an intense and enduring effect on their social and physical development, not to mention the cause of emotional and financial stress for the entire family.
Also, the earlier it’s treated, the better the prognosis, keeping in mind that there is a spectrum of conditions, with most pain being acute rather than leading to a long- term condition, she adds.
For shorter-term acute pain,
Ms Bennett says pharmacy assistants may be able to help parents manage the “more unpleasant side of things” beyond recommending paracetamol or other pain relief options.
She cautions though, that it can be very difficult for children and their
carers to navigate paediatric pain, because children cannot manage their medications, and some of the treatments required are not easily accessible.
“Side effects can also have a big impact on their development, so it’s
fundamental to get the right support and care as early as possible,” she said.
“Generally, we find that children tend to respond well to multidisciplinary pain management accompanied by self- management customised to their age.”
How can pharmacies make
a difference?
Pharmacists and pharmacy assistants already make a big and positive contribution to pain management
in Australia, across the age groups, Ms Bennett says.
“Primary healthcare is at the forefront in terms of making a positive difference as to how children’s pain is managed now and in future,” she said. “This makes it critical that pharmacists and their assistants are well versed in the pain conditions that affect children, how pain works and the range of children’s medications to treat it, followed by broader suggestions for pain management.”
She underscores that pharmacists should never underestimate how much they can help manage the complexities of pain management as a result of
their good handle on medication management and ability to navigate available drugs, and their local links to multidisciplinary services.
“So much is about knowing what best-practice approach works, which is usually seen as a multidisciplinary approach where primary healthcare providers work as a team and know what healthcare services are available in local regions, as well as knowing what to give a child to ease pain, like heat packs,” Ms Bennett said.
She highlights that some pharmacy programs focus on pain management education and training.
“I can’t stress enough how fundamentally important [these programs] are to pharmacists to have a better understanding of pain conditions and what tools work at relieving or eliminating different types of pain,”
Ms Bennett said.
“It’s all about good decision making based on education, support systems that work, and an array of tools that meet the requirements of specific situations, good medication reviews and sensitivity to negative drug interactions, as painkillers come with side effects and risks.
“Also of importance is knowing how to approach children in pain. Talk to
LITTLE LEGENDS 59 them and their carers to inform them
of available options and refer them appropriately in their local area.”
Many of these skills can be passed on to pharmacy assistants.
Ms Bennett cites programs such
as real-time monitoring, which offer an opportunity for intervention that can “really make a difference” when
it comes to pain management, but require upskilling by healthcare professionals who intend to make use of them.
“Pharmacists and their assistants really lend themselves nicely to be far more involved in supporting children and their carers to optimally manage their pain, know what to expect and where possible to take a more proactive and broader approach that includes pain management, healthy eating, adequate and bespoke exercise, psychological support, and insightful referrals because it’s a known fact that medication only plays a limited role in pain management,” she said.
Alvin Narsey, owner of Priceline Pharmacy West Brunswick in Melbourne, says that when parents present their children in pain, the pharmacy takes a holistic approach to it.
“On a physical level, I like to have the conversation about the child’s medical history, what the symptoms are and what the child thinks is causing the pain,” he said.
“Typically, though, the parents want
a quick fix, and when it’s suitable I recommend paracetamol or ibuprofen.”
Mr Narsey says chronic pain is the domain of GPs.
“This means I’m happy to suggest natural medications for adults, but not for kids. Where appropriate, I refer them on to a naturopath, which has proven beneficial,” he said.
Mark Webster, owner of Stay Well Pharmacy in Christchurch, New Zealand, says the problem with children in pain is that they struggle to verbalise their pain and show healthcare professionals and their carers where it’s located, especially if it’s in the abdomen.
He adds that he treats children with paracetamol or ibuprofen, a cold compress, and creams or ointments, depending on the situation.
“Oftentimes treating the child’s emotional state helps, like giving them a cuddle,” he said.
RETAIL PHARMACY ASSISTANTS • SEP 2020