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Editorial asserts need for more pain education among clinicians

When the term "Pain as the Fifth Vital Sign" was initially promoted by the American Pain Society in 1996 to raise awareness of pain treatment among health care professionals, VA quickly incorporated the slogan into its own philosophy of care.

VA developed an extensive toolkit to implement pain assessment and management in all its patients, and the Joint Commission, which accredits health care facilities, recommended in 2000 that pain be assessed in all patients throughout the nation.

In a recent editorial, Natalia E. Morone, MD, and Debra K. Weiner, MD, of the VA Pittsburgh Healthcare System and the University of Pittsburgh argued that the increased focus on assessing and documenting pain has had unintended consequences. They point out that there has been a near doubling of prescriptions of opioid medication in the last two decades, and an increase in prescription opioid-related unintended deaths.

The authors assert that the "fifth vital sign" has proved to be more complex to assess, evaluate, and manage than the American Pain Society, VA, and the Joint Commission originally anticipated. They argue that expanding pain education and training among clinicians is critical to remedy the issues that have emerged. (Clinical Therapeutics, Dec. 2013)

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