From WSAVA news April 2015
Dr Walt Ingwersen, WSAVA President Elect and member of the GPC explains why: All animals are sentient and can therefore feel pain and suffer from it. This makes pain management one of the most important topics in companion animal medicine, particularly as there is a wide variation in its assessment and management around the world. This is caused partly by the variability in pain treatment modalities from country to country and it results in a gap between pain incidence and adequate treatment.
Eliminating this pain incidence pain treatment gap is our key goal because the ability to actually diagnose pain is not dependent on regional differences. This is why we are focusing our efforts on education for the whole veterinary healthcare team.
Guidelines
In June 2014 the GPCs first major educational initiative, the GPC Global Pain Recognition, Assessment and Management Guidelines, were published in the Journal of Small Animal Practice (Matthews et al. (2014) JSAP 55: E10 E68).Based on extensive research conducted by GPC members, the Guidelines are a practical, downloadable resource to assist practitioners around the world by providing guidance in recognizing and assessing pain.
The Guidelines are accompanied by management protocols for a wide range of painful conditions. Because they also offer guidance on scenarios where analgesic agents are limited, the protocols help to empower veterinarians in these countries to recognize and treat pain, regardless of their limitations. They are available as one page resource documents, together with overviews of various common veterinary conditions and the pain associated with them at www.wsava.org.
Dr Ingwersen explains: To help us prepare the GPC Pain Guidelines we conducted a Global Pain Survey which provided a snapshot of pain management attitudes, treatment protocols and therapeutic modality access right around the world.
“We found a high degree of knowledge of the occurrence and importance of treating pain and that local anaesthetics are commonly available regardless of where in the world a veterinarian is practising. The problem is they are not routinely used. This is disappointing given their relatively low cost and effectiveness.The survey went on to show that the most common underlying impediment to their broader use was veterinarians’ familiarity with how to use to use them.
He continued: The GPC Global Pain Guidelines have been well received and have been downloaded more than 6500 times. They are being reviewed by our member associations and a number have already endorsed them with more planning to do so. Going forward, we aim to An empowered, motivated and globally unified veterinary profession that effectively recognizes and minimizes pain prevalence and impact BSAVA 2015 | companion APRIL 2015 | 27 translate these valuable resources into a range of languages to increase their accessibility. The full results of the Global Pain Survey are also available on the GPC pages at www.wsava.org
Now that the GPC Global Pain Guidelines are in place, Dr Ingwersen says that 2015 will see the GPC focus on delivering its messages on pain control to veterinarians around the world through a global education programme, comprising a number of elements:
WSAVA CPD and web-based resources
WSAVA Congress lectures on pain management will be recorded and made available as webinars on the GPCs web pages at www.wsava.org while GPC-led educational sessions will headline this year’s WSAVA World Congress. A series of online videos available for download from the WSAVA’s website are also in development.In addition, the GPC is sending its experts to regional veterinary CE events during 2015 and 2016 to help develop veterinary expertise in pain management around the world. A key component of its educational work is a teach the teachers’ initiative, focusing on key influencers and veterinary educators.
Collaboration with other associations
In addition to its role in veterinary education, the GPC leads the global debate on availability of pharmaceutical products that support the veterinarian’s diagnostic ability to manage a variety of conditions including pain. For instance, its members are participating in the debate over minimal analgesic requirements; the continued availability of certain analgesic modalities (e.g. ketamine), and the broader availability of a more complete complement of analgesic products. Dr Ingwersen said: An ability to manage our patients pain both acute and chronic is central to the work of a veterinarian so, during 2015 and 2016, we will use both the GPC Pain Management Guidelines and our knowledge of the regional realities of clinical and modality infrastructure to champion its importance and to provide education for veterinarians around the world.
– Peter Kronen DECVA; President AVA; Member of the Board of Directors IVAPM; and Honorary Secretary IASP SIG Non-Human Species; Switzerland
– Duncan Lascelles DACVS; pain researcher and author; USA
– Sheilah Robertson DACVA, DECVA; feline pain management and author; USA
– Andrea Nolan DECVPT, DECVA; pharmacology + pain research; Scotland
– Paulo Steagall anaesthesia; IVAPM board; pain researcher and author; Canada
– Bonnie Wright DACVA; alternative pain modalities; USA
– Kazuto Yamashita anaesthesiology and pain research; Japan
– Walt Ingwersen WSAVA President and WSAVA Executive Board liaisonWalt Ingwersen being rescheduled as a restricted drug. It is the mainstay of anaesthesia/analgesia in many developing parts of the world for both veterinary and human medicine so we think this move would be a backward step in terms of helping veterinarians globally to manage pain. Updates on our work are posted regularly on the GPC pages of www.wsava.org and we welcome feedback and insights from fellow veterinarians with an interest in this area.For more information or to contact the WSAVA Global Pain Council, please email wsavasecretariat@gmail.com.
The WSAVA and GPC would like to thank the following sponsors of their activities, without whose support its work would not be possible:
Phase I (Guidelines, Tiered Analgesic Protocols, and Global Pain Survey): Boehringer Ingelheim Animal Health, Elanco, Novartis, V©toquinol and Zoetis
Phase II (Education, web-based tools, lobbying and collaboration): Novartis, V©toquinol and Zoetis.
