Why pain matters

Pain affects people with a wide range of conditions and, with increasing evidence to suggest that medicines might not always be the answer, there is more need than ever for expert pharmacists to optimise medicines and help people to manage their pain, according to Professor Roger Knaggs (Specialist Pharmacist in pain management, Nottingham).

Professor Knaggs is an academic pharmacist who combines teaching and research in the School of Pharmacy at the University of Nottingham with hands-on clinical work in a community-based pain service, one day a week.  His interest in pain started when he first came to Nottingham as a PhD student. His research was related to morphine metabolism and pharmacokinetics. “Then, rather serendipitously, I moved into a specialist pharmacist role at what was then Queen’s Medical Centre (and is now part of Nottingham University Hospitals NHS trust) and I was the specialist pharmacist for anaesthetics and pain”, he recalls. Initially the work was mainly in acute pain but over a period of years he became more involved in chronic pain. “After several years of doing clinics together with some of our nursing colleagues, I started to develop my own clinics to look at optimising medicines for pain”, he says.

There are several reasons why all pharmacists should be interested in pain, he says. “First of all, it is such a common experience – so every pharmacist is going to see people who may experience pain and it is associated with many different diseases and illnesses.  In terms of chronic pain, the reason why pharmacists should be interested is there has been in increasing amount of evidence to actually say that medicines only work for a relatively small proportion of people. And so, perhaps the emphasis should be now much more around optimising medicines and people only continuing to take them over longer periods of time if they actually make some significant difference to reducing their pain and allowing them … to do more”, he explains.

Roger Knaggs BSc BMedSci PhD EDPM FFRPS FRPharmS FFPMRCA, is Associate Professor in Clinical Pharmacy Practice, University of Nottingham and Specialist Pharmacist in pain management, Primary Integrated Community Solutions Ltd.

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