Treatment of these multiple morbidities may result in polypharmacy, and a pharmacist could make a valuable contribution by conducting medication reviews. Although evidence supports a multidisciplinary approach to chronic pain, there is little evidence to support the inclusion of a pharmacist in chronic pain teams, particularly in primary Selleck Z-VAD-FMK care. An American primary care team comprising a pharmacist, physician and psychiatrist improved pain, depression and disability scores over three months in sixty-three patients with chronic pain.2 The aim of this

pilot study was to assess a new role for a pharmacist in a multidisciplinary chronic pain team in primary care. A pharmacist from Whittington Health was seconded to the MSK chronic pain service for one day per week from January – June 2012. Patients were triaged by compound screening assay a physiotherapist who decided on the most appropriate management, including physician, physiotherapist or psychologist input (or a combination of these management options). Patients who might benefit from a medication review were referred to the clinic pharmacist. For each referral, the pharmacist conducted a

medication review; the symptoms being treated and the medication taken by the patient were discussed, and an assessment of side effects and adherence issues was made. The following data set was recorded for each patient on a standardised data collection form: Number of medicines reviewed Number of actions taken Record of professional judgement for each action, including a description of the action taken and corresponding reasoning. Semi-structured interviews were Thymidylate synthase conducted with four physiotherapists in the MSK chronic pain service to assess the value of the pharmacist to the multidisciplinary team. Ethics Committee approval was not required for this study. Thirty-two patients attending the MSK chronic pain service had a medication review conducted by the clinic pharmacist. The mean number of medicines per patient was 3.5 (range 0 –17; total of 112 medicines). A total of eighty actions were taken, a mean of

2.5 actions per patient (range 0–7 per patient). 80% of these actions (n = 64) were to optimise the efficacy of treatment (Table 1). Table 1: Categories of actions taken by chronic pain clinic pharmacist Action type No. of actions Example Optimise therapy 64 Recommend addition of amitriptyline Reduce adverse effects 13 Advise regular use of laxative with dihydrocodeine Enhance adherence to medicines 3 Counselling on benefits of prescribed pain medication. Those interviewed indicated that the pharmacist added value to the team by providing specialist advice to patients, maximising adherence and improving the patient experience. A pharmacist working in a primary care chronic pain team provided advice to patients and their GPs aimed at optimising therapy, reducing adverse effects and enhancing adherence. The other team members indicated the pharmacist added value to the service.