The pain code - AMBER conversations
THE PAIN CODE – AMBER CONVERSATIONS
Typical ways your Amber customers may present and questions you can ask:
CURRENT TREATMENT HAS NOT ADEQUATELY RELIEVED ACUTE PAIN
Is pain interfering with daily activities despite treatment?
Options might be to 'step up' oral analgesia if appropriate. This could mean using paracetamol and ibuprofen together, or using a codeine-containing analgesic if one is not being used already. Seek advice from your pharmacist
Combine current medication with other pharmacy pain care options
Has the pain continued for more than 3 days despite treatment?
Advise that treatment might not be effective as drug tolerance develops.
Advise on alternatives as part of a broader pain management consultation. This is discussed later in the module.
CUSTOMER IS UNCERTAIN OR AMBIGUOUS ABOUT HOW LONG THEY HAVE BEEN TAKING ANALGESICS
What day did you start taking analgesic medication?
Have you taken it every day since then?
Uncertain usage is not evidence of misuse: adapt your questioning to help customers remember their medication history
If their analgesic contains codeine, remind the customer that codeine is not safe or effective beyond 3 days usage
CUSTOMER HAS VAGUE REASONS FOR REQUESTING CODEINE-CONTAINING MEDICATION
Pain relief can work in many different ways.
May I ask your reason for requesting codeine specifically?
Which other treatments have you tried that helped with the pain?
If the customer is evasive, try to understand and de-escalate any anxiety the customer might have around giving ‘wrong’ answers or not getting effective relief
Be prepared to refer the customer to the pharmacist if you are aware the customer has recently purchased codeine-containing analgesics on one or more occasions
THE CUSTOMER’S PAIN IS NOT ACUTE BUT ORIGINATES FROM A CHRONIC OR UNDERLYING CONDITION
How long have you had this issue? Have you seen your GP?
What do you think the source of the pain might be?
Have you had other symptoms in this part of your body?
If pain originates from a non-acute cause, such as a long-term injury or chronic condition such as cancer – try to uncover the situation and help the customer understand the source of their pain
You may need to refer the customer to the pharmacist to discuss alternative treatments