The Australian Pain Society DECEMBER 2014 NEWSLETTER Volume 34, Issue 10
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Editor’s Note Contents
This edition has a range of articles, from a 1 Editor’s Note 12 Home Medicine Reviews: Recent report by the president to a report on the changes and potential implications 2 Presidents Report IASP World Congress: so there is plenty for 14 IASP 15th World Congress on Pain your attention. 3 Simple accident leads to life of pain Report Thank you to all contributors and to Tra- 4 ASM 2015 registration open 15 Albury Wodonga Health Tackling Opioid cy at DC Conferences for her work in the 5 Paralympian launches new pain book Misuse newsletter. 6 In recognition of Jenny Phillips 16 PhD Student Travel Grants Wishing all our members a happy and re- 7 Olly Zekry wins PSA QUM in Pain 22 FYI & New members Management Award freshing summer break. 23 Membership renewal & Calendar Regards, 9 Sclerotomes and somatic referred of events (pain and other neurophysiological) 24 Calendar of events Will Howard symptoms Editor 10 Current & Past Scholars
APS NEWSLETTER I DECEMBER 2014 1 PRESIDENTS REPORT
By Dr Malcolm Hogg munity in pain management worked col- ety’s executive is hopeful the project will lectively to establish the discipline, with generate impetus to deal with the chal- steady growth thereafter securing the lenges ahead - challenges we should em- Society’s future. We are now considering brace. Thank you for your support and our role in the health care evolution, with ongoing membership of the Society, and an emphasis on member education, sup- best wishes for the new year ahead. porting the development of new models of service delivery, and research agendas. The society seeks engagement in the pro- cesses of reviewing the Australian Health Service standards, introduction of feder- al-state activity based funding, and work- force development programs in various states. With our support of painaustralia, the society believes it has established a structure to effectively lobby for appropri- ate change, in order to further strengthen Whilst the year draws to a close, prepara- health care system now and in the future.. tion for the coming year’s activities contin- ue. The timetable for our 35th ASM in Bris- - bane (15-18th March) is almost set, with creasingly aware of these changes, de- posters and free papers selected (thanks veloping position statements and pain to all those who submitted), and interna- special interest groups for their members. tional speakers engaged (Prof Herta Flor, It is imperative that the Society, and its Dr Mary Lynch, Dr Frank Porecca, Dr Tim members, take opportunities to promote - vited Australian speakers. Registration is now open, with the program available for models for our patients. Opportunities for review on our website (https://www.dccon- - ferences.com.au/aps2015/program_over- vances in the neuro- and social-sciences view). if service teams and their administrators remain committed and enthused to sup- - port change implementation. ing, the executive commissioned a histori- cal review which is underway and planned Our history project should celebrate our for release in Brisbane. The small com- Society’s achievements, and the Soci-
History of the Australian Pain Society
WE ARE DESPERATELY SEEKING PAST CONFERENCE ABSTRACT HANDBOOKS AND ANY PHOTOGRAPHS OR IMAGES OF PAST APS ACTIVITIES. We would welcome any contributions you could make to this project, please contact the Australian Pain Society Secretariat on (02) 9016 4343 or via email [email protected]. As required, all originals will be returned.
APS NEWSLETTER I DECEMBER 2014 2 SIMPLE ACCIDENT LEADS TO LIFE OF PAIN
- rived at after four and a half years, was the Ms Mantalvanos agrees. She is also the her pain. Today, two and a half years af- which documents the effect chronic pain live with it”. ter the diagnosis, Ms Mantalvanos’s pain has had on her life (see www.pudendal- is better managed and she uses an elec- Soula Mantalvanos was working in her tronic implant, which distracts signals of graphic design studio seven years ago pain to her brain. She has also become of chronic pain in the community. She is - a strong advocate for better recognition, also working with pain professionals in WA ance ball or exercise ball) she was sitting treatment and management of chronic to produce a pain management program. on in place of a chair unexpectedly burst pain. beneath her. Ms Mantalvanos fell from a “It is still a primitive time in pain. Being told for four and a half years ‘this is chronic her sacropelvic region bearing the full New Zealand suffer from chronic pain, yet pain ... go home and live with it, there’s force of the blunt fall. the condition remains little understood. nothing that can be done’ is brutal not to mention primitive.” Her husband Theo ran to her side. Af- This message was the theme of the ter the shock settled, she crawled to the ANZCA Anaesthesia and Pain Medicine Ebru Yaman carpeted area and her response was to Foundation’s “1 in 5” television campaign ANZCA Media Manger laugh. The pair “had a good old laugh ac- launched in July to spread awareness of Clockwise from left: Soula Mantalvanos in her studio; tually – it was such a silly accident,” she chronic pain. The commercial can be seen a still from the television campaign; self-portrait: remembers. at www.anzca.edu.au/fellows/ foundation. Finalist in The Doug Moran Portrait Painting Prize That unexpected and seemingly innocu- Ms Mantalvanos is one of the chronic pain 2014. ous accident would determine the course patients who volunteered their services to of the rest of her life. Ms Mantalvanos ex- appear in the commercial, which encour- pected to feel sore but better after a cou- ages the public to donate to research into ple of days. But the pain continued, inten- chronic pain. The Dean of ANZCA’s Faculty of Pain days, her nights, her relationships and her Medicine, Professor Ted Shipton, said ability to work. chronic pain had many causes and was - a complex and debilitating condition that swers, of tests and interventions, frus- desperately needed more research. tration, grief, and constant, unbearable - pain to reach a diagnosis. The fall caused ments and develop better understanding nerve damage in the pelvic area, very of the mechanisms at work in this condi- real but invisible on MRIs, examinations, tion – and for that we need more dedicat- X-rays and CT scans. ed research.” The diagnosis of pudendal neuralgia, ar-
APS NEWSLETTER I DECEMBER 2014 3 ASM 2015 REGISTRATION OPEN
REGISTRATIONS OPEN
2015 Australian Pain Society 35th Annual Scientific Meeting Managing Pain: from Mechanism to Policy
15 - 18 MARCH 2015 | BRISBANE CONVENTION & EXHIBITION CENTRE, QLD
Expressions of Interest online at www.dcconferences.com.au/aps2015 For Sponsorship and Exhibition opportunities or more information please contact the APS Secretariat DC Conferences Pty Ltd | P 61 2 9954 4400 | E [email protected]
Registration for APS 2015 is now open. Early Bird Deadline is Friday 23 January 2015 Registration Fees and Information To register, please click on the following link: Register Online Now
Conference program Conference website
The program this year will focus on key topics including: brain pain, Program overview immune stressors, acute pain, chronic pain, opioids, neuromodulation, emerging interventional techniques, paediatrics, physiotherapy, Keynote speakers psychology and much, much more. Looking for more information? Click on one of the following links: Pre-Conference Workshops
We look forward to welcoming you to Brisbane.Should you have any queries, please contact the Conference Secretariat.
APS NEWSLETTER I DECEMBER 2014 PARALYMPIAN LAUNCHES NEW PAIN BOOK
L to R: Rebecca McCabe, Kathryn Nicholson Perry (back), Liesl Tesch AM, Robin Murray (back), Lyndall Katte and Phillip Siddall
a particular focus on pain following spinal cord injury. They include chapters on med- Liesl Tesch AM, six time Paralympian ications and other treatments, stretching, and gold medallist launched The Spinal exercise, diet, distraction, relaxation, Cord Injury Pain Book at an event that was part of both the Global Year against Neuropathic Pain and Spinal Awareness people living with someone with pain. The book also has many quotes from people the more than two thirds of people with a with spinal cord injuries who tell their own spinal cord injury who experience pain of personal stories of living with pain and some sort. Neuropathic pain is also a ma- what has helped them. jor problem and occurs in around one half of all people with a spinal cord injury. The book forms part of a larger bunch of Liesl Tesch AM resources for people with pain following spinal cord injuries launched in October. The book has been written by The Pain The resources are available through the Book authors, Philip Siddall, Rebecca NSW Agency for Clinical Innovation web- McCabe and Robin Murray at Greenwich site: Hospital in Sydney with two additional au- thors who bring a huge amount of experi- www.aci.health.nsw.gov.au/chronic-pain/ ence in treating people with pain following spinal-cord-injury-pain. spinal cord injury, clinical psychologist A/ The book can be purchased on-line or Prof Kathryn Nicholson Perry and physio- directly from the publisher at www.ham- therapist Lyndall Katte. mond.com.au/shop. book contains information on pain mech- anisms, the impact of pain and the various treatments available but with additional spinal cord injury. The second part of the book has been largely rewritten to provide
APS NEWSLETTER I DECEMBER 2014 5 IN RECOGNITION OF JENNY PHILLIPS
In recognition of the achievements of Jenny Phillips. The retirement of a pain management champion.
In 2000 when Jenny joined the Acute Pain closely in the RDH Department of Anaes- Service as the Clinical Nurse Consultant thesia. the position was still only part-time. Since Jenny’s achievements have been rec- then Jenny’s responsibility has grown ognised by her peers with her nomination along with the service provision and the and subsequent awarding of the NT Acute number of patients referred to the Acute Care Nurse of the Year award at the NT Pain Service has quadrupled to over 2200 Nursing and Midwifery Excellence Awards referrals in 2013. Jenny has been a part in 2009. Her commitment and passion for her role and her ability to inspire others management in the NT over her career, to improve pain management for patients particularly in pain management education was recognised at the awards. and the promotion of change in practice to improve patient outcomes. Jenny has Jenny’s contribution also included being implemented pain management courses the NT Director for the Australian Pain So- for staff, been the lead for the introduction ciety for the last three years. of safe and effective continuous infusion On the 22nd of October Jenny Phillips, the Jenny will be greatly missed at RDH. She pump therapies, and has empowered oth- Royal Darwin Hospital (RDH) Acute Pain is looking forward to spending more time er nurses to deliver more effective pain Service Clinical Nurse Consultant (CNC), with her family and grandchildren. Her management for patients with acute pain. retired after 14 years in the role. Jenny parting message to us was: “if you are in- She has also been pivotal to better com- came to work at RDH in a surgical ward terested in pain management then get into munication with primary care providers, from Melbourne in 1997. She was moti- - providers of care for patients with chronic vated to become involved with the acute cessful patient outcomes is very rewarding pain and those with alcohol and other drug pain service as she always had a passion especially when you have the knowledge addiction. for but frustration with pain management to change practice and improve care.” since the so called ‘pethidine days’, and Jenny has taken the nursing lead in the a desire to see positive change in patient development of policies, procedures and care. guidelines for the care of patients with acute pain and the implementation of The Acute Pain Service at RDH was start- these across the RDH. She has also been ed in the early 1990’s by the then Direc- a resource for other Hospitals across the tor of Anaesthetics Dr Hamish Holland. At NT. Jenny has the respect and trust of the this time a Registered Nurse only worked medical staff throughout RDH and in par- a couple of hours per day with the service. ticular those with whom she worked most
Have you had an article accepted for publication this year?
Reminder that we are keen that members inform us when they have publications so that this can be shared with your APS colleagues. Please send the newsletter editor (via the APS Secretariat, [email protected]) the title, authors and reference (i.e. the journal, volume etc.) of the article, preferably with a short explanatory note to give our readers the gist of the article, e.g. the conclusions part of the abstract; if you would like to supply a short commentary on the article, even better. Will Howard, Editor
APS NEWSLETTER I DECEMBER 2014 6 OLLY ZEKRY WINS PSA QUM IN PAIN MANAGEMENT AWARD
sponsored by Mundipharma – at PAC14, “Under her stewardship, the course is now were PSA National President Grant Kar- an interactive online two-week revision, dachi and Mundipharma’s External Affairs followed by six case-based pain topics Manager, Tathra Chai. over two weeks each, along with a short answer question and two longer case Mr Kardachi said Ms Zekry had shown study questions.” HMRs to be very cost-effective, prevent- ing unnecessary hospitalisation due to medication misadventure by providing ed- well over 900 cases of undiagnosed neu- ucation and timely reviews. ropathic pain. “Ms Zekry is passionate about pain man- “She has always believed that the goal of agement and this prompted her to study all patients living with chronic pain, regard- Photo L to R: Mr Grant Kardachi, Ms Olly Zekry for the Masters Degree in Pain Manage- less of their medical history, is to improve and Ms Tathra Chai ment through the Faculty of Medicine, function, reduce pain perception, enhance University of Sydney in 2011 and 2012,” quality of life and minimise side effects,” NSW medical centre pharmacist Olly Ze- Mr Kardachi said. Mr Kardachi said. kry has won the 2014 PSA Award for QUM in Pain Management. “Because of her passion for the area and Ms Chai congratulated Ms Zekry saying her strong grasp of pharmacology and “Mundipharma is proud to again sponsor Ms Zekry advocates strongly for pharma- pain pharmacology, she was invited to the Pharmaceutical Society of Australia cists to play a key role in pain manage- join the Pain Management Research Insti- Award for QUM in Pain Management be- ment and in preventing the progression of tute (PMRI) with the Faculty of Medicine, cause this award recognises those phar- acute pain to chronic pain by clinical inter- Sydney University, as a tutor for the phar- macists who making outstanding contri- ventions and patient education. macology units for the core subject PAIN butions to the quality use of medicines She believes pharmacists can identify red 5003 Pain Treatment and Management through direct clinical care of consumers.” Principles in 2013. - “As the 2014 recipient of this award, Ms otal role in the progression of acute pain “In addition, she was invited this year to be - to chronic pain. Increased understanding course coordinator for the pharmacology bution through her own clinical practice of the mechanisms of acute pain and risk units for the core subject PAIN 5003 Pain where she undertakes pain medication factors for progression to chronicity has Treatment and Management Principles, reviews and supports patients to achieve led to improvements in clinical manage- and also course coordinator for the elec- their goals to reduce pain and improve ment. tive subject PAIN 5015 Pharmacology of function, but further extends her contri- Jointly presenting the award – which is Pain Medicine and in fact to rewrite and bution through her commitment to profes- run the whole unit. sional education.”
You are invited to attend the Pharmacological Management in Pain Pre-Conference Workshop
Sunday 15 March 2015, 8.30 am – 1.00 pm Brisbane Convention and Exhibition Centre, QL $110 per person – Early Bird Deadline: 23 January 2015
www.dcconferences.com.au/aps2015/Pre-Conference_Workshop
APS NEWSLETTER I DECEMBER 2014 7 SCLEROTOMES AND SOMATIC REFERRED (PAIN AND OTHER NEUROPHYSIOLOGICAL) SYMPTOMS
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- alises or recalls that each limb arises from Clinically, being aware of the extent of seven or so limb “buds”. These are con- sclerotomal segmental innervation assists densations of mesenchymal cells which one come to terms with some of the weird gradually stretch out to form the entire and wonderful pain maps and descriptions Society limb. Thus, for example, L5 can stretch supplied by our patients with persistent from the L5 vertebra, heaven forbid the pain issues. Whilst it is helpful to think of dura also, to the great toe. Ipso facto the pain as travelling outwards from the trunk innervation of the structures arises from as water does downhill, being aware of the same neurophysiological segments. sclerotomal distributions helps under- stand why lumbar back pain may arise - from the more “distal” hip joint. Of course, drome would certainly be aware of this there may well be separate and concur- concept. McCredie and Willert (1999)1 rent pathologies, but not always. and Inman, Saunders and Abbott2 provide excellent diagrams and further explana- - tion of sclerotomes. agnostic interventional practice. Time and again I am reminded of the presence of sclerotomes, usually spontaneously by my patients undertaking generally spinal procedures describing relief of pain or discomfort in areas where there was no expected such relief, such as in the foot. Understanding sclerotomes has been a valuable adjunct in my clinical practice of musculoskeletal medicine. I came across it back in the mists of time during my reg- istrar training days in the 1980s and it was told to me by one or more of Drs Weiner, Ganora, Gyory, Bogduk or the good folk at AAMM (Australian Association of Mus- culoskeletal Medicine), a medical organ- (ASM) I would wholeheartedly recom- - I encourage reading of the original article loskeletal and pain medicine). I was dis- by Inman, Saunders and Abbott of 1944. combobulated at the recent AFRM ASM There is also the marvellously instruction- to observe that many of my colleagues do al article by Kellgren and Lewis3 of c.1949 not appear particularly familiar with this showing distribution patterns of referral of construct. This led me to consider writing pain from irritated spinal structures in vol- this short educational article as a means of my own reviewing of the concept. Of course there are the more recent clin- We are all familiar with dermatomes, al- ical iterations of cervical (Dwyer et al though there have been several models 1990)4, thoracic and lumbar segmental developed over the last century with the referral patterns published in Spine and as taught by the International Spine Inter- failed exams if not familiar with myotomal vention Society. segmental distribution (such as L5 inner- References: vating hip extension as well as great toe 1. McCredie J, Willert H-G 1999. Longitudinal limb de- limb). But sclerotomes? These can be thought of 2. Inman V, Saunders M, Abbott L 1944. Referred pain from skeletal structures. Journal of Nervous and Men- in terms of the remainder of the volume tal Disorders; 99:660–667. of that limb or portion of the body. This 3.Lewis T., Kellgren J.H.. Clin. Sci. 1949; 4: 47 includes bones, tendons, ligaments, cap- sules, and even neurovascular bundles. 4. Dwyer et al Spine 1990 They are easy to understand when one re-
APS NEWSLETTER I DECEMBER 2014 8 CURRENT & PAST SCHOLARS
CURRENT SCHOLARS:
PhD Scholarship Sponsor Mundipharma #3-APS-APRA Scholar Audrey Wang Topic An investigation of the role of the brain in recovery from CRPS, using fMRI” PhD Scholarship Sponsor Janssen Cilag #2-APS-APRA Scholar Sarah Kissiwaa Topic Pain induced synaptic plasticity in the amygdala” PhD Scholarship Sponsor APS #5-APRA Scholar James Kang Topic Epigenetic influence in cognitive impairments in chronic neuropathic pain”
PAST SCHOLARS:
PhD Scholarship Sponsor APS #1-APRA Scholar Samantha South Completed 1999 Topic Antinociceptive pharmacology of morphine and its major glucuronide metabolites” PhD Scholarship Sponsor CSL #1-APS-APRA Scholar Lara Winter Completed 2004 Topic Antinociceptive properties of the neurosteroid alphadolone” PhD Scholarship Sponsor CSL #2-APS-APRA Scholar Anne Pitcher Completed 2006 Topic Conditional comfort: A grounded theory study in nursing approaches to acknowledging and responding to pain in nursing home residents with dementia” PhD Scholarship Sponsor Mundipharma #1-APS-APRA Scholar Kathryn Nicholson Perry Completed 2007 Topic Pain Management Programmes in Spinal Cord Injury: Cognitive Behavioural Pain Management Programmes in the Management of Sub-acute and Chronic Spinal Cord Injury Pain” PhD Scholarship Sponsor APS #2-APRA Scholar Debbie Tsui Completed 2008 Topic Preclinical studies in painful diabetic neuropathy”
APS NEWSLETTER I DECEMBER 2014 9 PAST SCHOLARS
PAST SCHOLARS:
PhD Scholarship Sponsor Mundipharma #2-APS-APRA Scholar Zoe Brett Completed 2011 Topic Individual differences in vulnerability to the development of chronic pain following injury” PhD Scholarship Sponsor APS #3-APRA Scholar Susan Slatyer Completed 2013 Topic Caring for patients experiencing episodes of severe pain in an acute care hospital: Nurses’ perspective” PhD Scholarship Sponsor Janssen Cilag #1-APS-APRA Scholar Mary Roberts Completed Due 2013 Topic An investigation of the role of sleep in chronic pain” PhD Scholarship Sponsor APS #4-APRA Scholar Amelia Edington Completed 2013 Topic Defining inhibitor binding sites unique to the glycine transporter, GLYT2: A potential target for the treatment of chronic pain”
Congratulations to the Philip A. Spiegel IASP Congress Trainee Scholarship Winner
This scholarship was established in 2011 with functional neuroimaging. She graduated by IASP and friends and family of Philip A. from Physiotherapy in 2008, completing an Spiegel, a young medical researcher and Honors dissertation on perceptual dysfunction IASP member who died December 22, 2010, in chronic low back pain. After graduation in San Mateo, California, USA. He suffered she worked in an inter-disciplinary pain from Complex Regional Pain Syndrome and management center in regional Western was planning to enter medical school to study Australia for eighteen months. In addition, pain management. she earned a highly competitive Australian Postgraduate Award Scholarship and moved The award honours a young IASP member to Sydney to complete her PhD with Professor who suffers from Complex Regional Pain Lorimer Moseley at Neuroscience Research Syndrome. Recently, at the IASP World Australia. Dr. Di Pietro wishes to pursue Congress in Buenos Aires, Dr. Maged El neuroimaging research in pain and has Ansary presented the award to Flavia Di Pietro, developed a curiosity in the methods by which then a PhD candidate, from the University of we analyse and interpret brain imaging data. New South Wales She is very excited to be working with fMRI Flavia Di Pietro was recently awarded her while it is still in stages of rapid progress and PhD on brain mechanisms in chronic pain improvement.
APS NEWSLETTER I DECEMBER 2014 HOME MEDICINE REVIEWS: RECENT CHANGES AND POTENTIAL IMPLICATIONS
Earlier this year, plinary approaches to improving medica- Rationale for the latest tion management including collaborative - changes home medicines reviews.9 - extend beyond the prevention and resolu- tion of ADRs, and include the opportuni- Following the Pharmacy Guild’s strategy ty to educate, identify and resolve issues in 2010 to increase HMR uptake a high- associated with suboptimal patient under- er than anticipated spike in demand for standing of their medicines, underuse of HMRs was observed towards the end of medicines and untreated indications.2,5,12,13 2012.4 By 2013, the HMR program had HMRs have been shown to enhance the exceeded its allocated budget by $4.2 continuity of care between tertiary and pri- - mary care through medication reconcilia- increasing demand, the most recent HMR - tion, thus improving the transition between changes were proposed to “ensure pro- hospital and community care, which is a gramme sustainability” by limiting HMR risk factor for further hospitalisations.14,15 services and hence program spending.1 - Although much of the allocated $52.11 million remains to be spent, the 5CPA is up for renegotiation next year, and given Cost-effectiveness of the Commonwealth’s budgetary pres- 1 the HMR program sures, continual funding of HMRs is not guaranteed.4 The Value of Medication Reviews (VALM- ER) study, undertaken to assess the clin- ical and economic outcomes of HMRs in Clinical benefits of the Australia, demonstrated minimal short- HMR program - ciated with HMRs in the context of a broad The value of HMRs in improving patient safety through the minimisation of medi- Home Medicine Review reductions in health care utilisation costs cation errors when targeted to patients program: overview and improved quality of life, only negligible at high risk has been demonstrated in average net savings would be conferred retrospective cohort and implementation within the short-term, and HMRs were not Home Medicine Reviews (HMRs) assess studies conducted in the Australian set- found to be cost-effective overall.2 Howev- a patient’s use of medicines. The main ting.5,6,7 In Australia, a review of all hospital er, just 16% of VALMER patients account- objective is to optimise quality use ofmed- admissions studies highlighted that 2-3% ed for most of the savings.2 For VALMER icines and reduce drug-related problems, (approximately 230 000) of admissions study patients associated with savings in including adverse drug effects (ADEs). Ini- were medication-related.8,9 The associ- the upper quartile, the average calculated tiated by general practitioners (GPs) and ated annual costs of these ADE-related saving was $632.15, versus an average facilitated by pharmacists, the program admissions (ADE-RAs) are estimated at has been operational for over 12 years $1.2 billion.9 It is estimated that 50% of VALMER 2009).2 So although widespread under Medicare.2 Currently, the program such admissions are preventable and that use of HMRs has limited costeffec tive- is funded under the 2010 Fifth Communi- they account for up to 16% of emergency ness within the short-term, the targeted ty Pharmacy Agreement (5CPA) between department admissions.10 The associated use of HMR for those patients most likely the Commonwealth and the Pharmacy cost burden ADEs impose on primary care Guild, which extends until 2015.2 Under is uncertain, but observational studies of the 5CPA, $15.4 billion has been allocated general practice activity have revealed to community pharmacists, $663 million that 11% of patients have experienced an of which is for the delivery of profession- adverse drug reaction (ADR) within the Patients who benefit al services, including the HMR program.3 previous six months, and 11% of these most from HMRs - were categorised as severe.11 located budget of $52.11 million.3 A recent review of medication safety in Australia found growing evidence in the Within the literature, numerous Australian - studies have been conducted that high- light distinct patient cohorts for whom pro-
APS NEWSLETTER I DECEMBER 2014 11 HOME MEDICINE REVIEWS: RECENT CHANGES AND POTENTIAL IMPLICATIONS
prove the timely delivery of HMRs. This Pract, 17(1), 104-110. care savings, accompanied by improved can delay time to next hospitalisation and patient outcomes.6,7,16 This includes pa- reduce ADE-related GP visits, particularly Ryan P, Peck R, etal. (2009). The effectiveness of collaborative medicine reviewsin delaying time to tients treated with warfarin, one of the for those who are discharged from hospi- next hospitalization for patients with heartfailure in the leading medicines associated with hos- - Fail, 2(5), 424-428. pital ADE-RAs.7 Patients provided with a tion misadventure.15 A potentially viable HMR had a 79% reduction in their like- model of facilitating this involves hospi- P, Peck R, etal. (2011). Collaborative home medicines 15 lihood of next hospitalisation related to tal-initiated medication reviews (HIMRs). review delays time tonext hospitalization for warfarin warfarin-associated bleeding, between Although there is funding planned under associated bleeding in Australian war veterans. J Clin Pharm Ther, 36(1), 27-32. two- and six-months post-HMR.7 After six the 5CPA for HIMRs, the current lack of 8 Australian Council for Safety and Quality in Health Care. (2002). Second National Report on Patient 15 This indicates the need for more frequent rolling out such programs. Safety Improving Medication Safety. Canberra: The monitoring, which may potentially include Australian Council for Safety and Quality in Health Care. six-monthly reviews.7 Such patients who are now faced with restricted access to 9 Australian Commission on Safety and Quality in Health Care. (2013). Literature Review: Medication HMRs may soon be placed at greater risk Conclusions Safety in Australia. of warfarin-associated bleeding hospital- 10 Phillips A, Nigro O, Macolino K, Scarborough K, isations. Doecke C, Angley M, et al. (2014). Hospital admissions There is much debate to be had over the caused by adverse drug events: an Australian Similarly, the application of HMRs to pa- implications of these recent HMR program prospective study. Australian Health Review 38(1), 51-57. tients treated with heart failure medicines changes for certain cohorts of patients and has been shown to be effective in delay- health care resources. The recent restric- Harrison C, et al. (2012). General practice activity in ing time to hospital readmission related tions represent a generalised approach; Australia 2011–12. General practice series no.31. The to heart failure.6 Furthermore, numerous however, current evidence for effecve im- University of Sydney. plementation of HMR for those most likely 12 Stafford AC, Tenni PC, Peterson GM, Jackson SL, increase the risk of hospital ADE-RAs, particularly for older people and these ac- that this is unlikely to meet the needs of pharmacists. Pharm World Sci, 31(2), 216-223. those at greatest risk for ADEs. Thus, per- count for over 30% of hospital admissions in those aged 75 years and over.17 haps it would be more reasonable to con- sider exemption of particular cohorts of medication reviews in patients with chronic heart Such studies provide a foundation upon failure: a randomised clinical trial. Int J Cardiol, 159(2), patients from these restricons, parcularly which policymakers and researchers can 139-143. - - 14 Ellitt GR, Engblom E, Aslani P, Westerlund T, Chen TF. (2010). Drug related problems after discharge from associated with the provision of HMRs on an Australian teaching hospital. Pharm World Sci, HMRs at an acceptable cost. 32(5), 622-630. a more frequent basis. 15 Angley M, Ponniah A, Spurling L, Sheridan L, Although the current evidence does not Colley D, Nooney V, et al. (2011). Feasibility and Timeliness of Alternatives to Post-Discharge Home provide stakeholders with all the answers Medicines Reviews for High-Risk Patients. Journal of Alternatives to about how best to restructure HMRs and Pharmacy Practice and Research, 41(1), 27-31. the new program whom to target, it does provide a solid ba- sis on which to begin that process without AL. (2010). Prevalence of potentially hazardous drug framework unduly placing patients at risk. Pharmacol, 70(2), 252–257. 17 Easton K, Morgan T, Williamson M. (2009). HMR is by no means the only solution Medication safety in the community: A review of the to preventing medication errors. Studies literature. Sydney: National Prescribing Service. have demonstrated the potential value of References postdischarge collaborative management SL. (2011). A role for pharmacists in community-based post-discharge warfarin management: protocol for programs for patients prescribed warfa- 3 Australian Government Department of Health. the ‘the role of community pharmacy in post hospital rin, whereby other interventions such as (2013). Fifth Community Pharmacy Agreement Fact management of patients initiated on warfarin’ study. Sheet.
APS NEWSLETTER I DECEMBER 2014 12 IASP 15TH WORLD CONGRESS ON PAIN REPORT
I was given a wonderful opportunity to at- tend the IASP World Congress and pres- ent a poster titled “A systematic review of the measurement properties of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) and self reported ver- sion (S-LANSS) ”. This topic will become a chapter in my thesis. One of the busiest stalls was the book- The week was full of high quality, evidence stand, with discounts given to a selection based presentations from world leaders in of IASP listed books and signings by the pain. Key topics were covered in plenary sessions. Topical workshops, lasting one hand instead of reviewing them electron- and a half hours, usually with three speak- ically. They will no doubt provide some ers, covered different aspects of a range enjoyable light reading for our illustrious of topics. A common topic was neuropath- ic pain: presenters included world leaders The trainee workshops and networking Professor Bouhassira, Associate Profes- session was an excellent initiative and sor Nadine Attal and Professor Rolf-Detlef provided tips across many areas for stu- Treede. dent related issues including “your grant Stephanie is a PhD student at The The simple way these complex topics in review” and “how to get published in George Institute for Global Health, Syd- were delivered allowed me to learn valu- PAIN”. They were most informative. ney Medical School University of Sydney, Australia. able up-to-date information, consolidating my knowledge and understanding of neu- went by very quickly. It was a great oppor- Thesis title: Management of neuropathic ropathic pain research and its implemen- tunity to review neurobiochemistry, phar- pain and sciatica. tation into clinical outcomes. macology and how the implementation of One popular presentation was “combina- research translates into positive clinical tion therapy for neuropathic pain and oth- outcomes. The calibre of delegates under er pain conditions: similarities, differences one roof was phenomenal and the knowl- and therapeutic opportunities”. Approxi- edge each of those esteemed leaders mately 200 delegates attended. Professor holds is something to aspire to. Ian Gilron set the scene with a case study I’m sure everyone who attended can rec- of a 71 yo male having some pain relief ommend the next IASP congress in Yoko- with pregabalin but suffering various side hama in 2016. effects. The question raised was “is there do we add on therapy”? Research shows there is limited evidence to support the use of combination drug therapy in this scenario.
APS NEWSLETTER I DECEMBER 2014 13 ALBURY WODONGA HEALTH TACKLING OPIOID MISUSE
won’t go away, there is now evidence that gaining an understanding of chronic pain and consistently applying the concepts taught in the program, including under- taking a graded activity program, can over time reverse some of the central nervous system changes that have occurred and reduce pain, which is a massive break- through,” she said. “We now spend a lot of time educating our patients about how this is possible, by teaching them the basics of neurophysi- ology. We teach them the mechanisms that cause them to experience pain, and techniques to reduce sensitisation of their nervous systems. With this approach, it is easier for them to understand the reason- ing behind the strategies we teach, help- ing them to stay motivated to make long- term changes.” For more information about the program, contact Dr Langenegger esther.langeneg- [email protected] Manager of the Pain Management Pro- walking and hydrotherapy, as well as gram at Albury Wodonga Health, Dr Es- Cognitive Behavioural Therapy and other ther Langenegger, is concerned about the techniques to teach people to think differ- rise in opioid misuse in the region and be- ently about their pain, reduce fear, and lieves the best way to tackle it, is through learn to manage their mood. a multidisciplinary pain management ap- Most participants achieve some reduction proach. of their medication use while in the pro- “Unfortunately there is a broad miscon- gram and are provided with a plan to help ception in the community and even among reduce it further after discharge. some healthcare providers that chronic The program is delivered by a multidisci- pain is merely an extension of acute pain plinary team, including Dr Langenegger, and can be treated with the same modali- who has expertise in musculoskeletal ties of medication, rest and other passive medicine, along with physiotherapists, interventions,” she said. occupational therapists, psychologists, a “It is a big issue in our region and some- nurse and allied health assistants. thing we try to identify in our screening Ten programs are delivered each year, process, referring patients to drug and al- with about 10 patients in each, not just cohol counselling if necessary before ac- from the local area, where there is only cepting them into our program.” one pain specialist, but also from as far Running since 1995, the Pain Manage- away as Melbourne, Wagga Wagga, Can- ment Program at the public hospital in bera, Mildura and even the coastal region. Wodonga, Victoria, is the only residential Despite this demand, the wait list for initial pain management program outside of the assessment is currently just two months, nearest major cities Melbourne and Syd- with entry into the program usually within ney, and is offered at no cost to patients. a further two to three months. Requiring participants to live-in for a pe- Managing the program since 1997, Dr riod of three weeks, the focus is on edu- cation, developing self-management skills change in how the program is delivered in and reconditioning the body. recent years. Using a rehabilitation model, most days “Whereas once we told people they have include an exercise program including to learn to manage chronic pain because it
APS NEWSLETTER I DECEMBER 2014 PHD STUDENT TRAVEL GRANTS
Australian Pain Society PhD Student Travel Grants Application Form Brisbane 15-18 March 2015
The Australian Pain Society (APS) is • Current membership of the 1. Travel Grant awards will be made pleased to announce the availability of a Australian Pain Society (you can number of Travel Grants up to the value join now at: APS Membership). Programming Committee (SPC) of $500 for PhD students to present their Applications from non-members will 2. The principal eligibility factor will be not be considered. the quality of the submitted abstract. Meeting (ASM) of the APS to be held in • Acceptance of an abstract of your Brisbane on 15-18 March 2015. 3. Only one author per abstract may research presentation. apply. This author must have made a This Travel Grant program is made • Presentation of your research in major contribution to the work. possible through an allocation of APS either oral or poster format. operating funds and only available by submitting a completed application form • Applicants must live outside the by 16th February 2015 and receive their by to [email protected] metropolitan area of the conference Travel Grants at the ASM. city.
Title: First Name: Last Name:
Address: Work Home
Street:
Suburb: State: Postcode:
Tel: Mobile:
Email:
Abstract title:
Type of Degree:
Educational Institution:
APS NEWSLETTER I DECEMBER 2014 15
BLOG
Research partnership opportunities
The Australian Pain Manage- groups, a comprehensive website, facebook and social ment Association Inc. (APMA) media presence, and high quality newsletters and other is a consumer health organisa- publications, and the delivery of presentations and com- tion for all Australians who live munity education. with persistent pain. APMA is a APMA is seeking to partner with researchers and health charity which promotes health practitioners working in the areas of pain management by providing advocacy, infor- and self-management who wish to seek NHMRC re- mation and practical support search funding for research about such services in order for people living with persistent to effect changes in the delivery, organisation, funding (chronic) pain and their families. and access to pain management services. Please con- APMA services include advice and information to peo- tact APMA CEO Elizabeth Carrigan on 0438 000 841 or ple with pain and the health community via a telephone [email protected] to discuss poten- helpline ( ), a national network of pain support tial research opportunities.
REGISTER ONLINE FROM 1 MAY 2014
3-5 December 2014 Southbank Institute of Technology, Brisbane www.50shades conference2014.com.au
APS NEWSLETTER I DECEMBER 2014 16 You are invited to attend the Acute Pain Day Pre-Conference Workshop
Sunday 15 March 2015, 8.30 am – 5.00 pm Brisbane Convention and Exhibition Centre, Queensland $165 per person – Early Bird Deadline: 23 January 2015
www.dcconferences.com.au/aps2015/Pre-Conference_Workshop
You are invited to attend the Fundamentals of Pain Pre-Conference Workshop
Sunday 15 March 2015, 8.30 am – 5.00 pm Brisbane Convention and Exhibition Centre, QL $165 per person – Early Bird Deadline: 23 January 2015
www.dcconferences.com.au/aps2015/Pre-Conference_Workshop
APS NEWSLETTER I DECEMBER 2014 17 You are invited to attend the Pharmacological Management in Pain Pre-Conference Workshop
Sunday 15 March 2015, 8.30 am – 1.00 pm Brisbane Convention and Exhibition Centre, QL $110 per person – Early Bird Deadline: 23 January 2015
www.dcconferences.com.au/aps2015/Pre-Conference_Workshop
You are invited to attend the Physiotherapy in Pain Management Pre-Conference Workshop
Working with a Pain Specialist and GP in primary/ secondary healthcare Understanding Chronic Low Back Pain Quantitative Sensory Testing and its relevance to neuropathic pain presentations
Sunday 15 March 2015, 1.30 am – 5.00 pm Brisbane Convention and Exhibition Centre, QL $110 per person – Early Bird Deadline: 23 January 2015
www.dcconferences.com.au/aps2015/Pre-Conference_Workshop
APS NEWSLETTER I DECEMBER 2014 18 2015 Australian Pain Society 35th Annual Scientific Meeting Managing Pain: from Mechanism to Policy S U B M I S S I O N D E A D L I N E S Topical Sessions 16 July 2014 15 - 18 MARCH 2015 | BRISBANE CONVENTION & EXHIBITION CENTRE, QLD Free Papers & Posters 3 October 2014 Expressions of Interest online at www.dcconferences.com.au/aps2015 For Sponsorship and Exhibition opportunities or more information please contact the APS Secretariat Early Bird Registration 23 January 2015 DC Conferences Pty Ltd | P 61 2 9954 4400 | E [email protected]
K E Y N O T E S P E A K E R S
Professor Herta Flor Professor Flor has Dr Mary Lynch is Professor of Anesthesia, Dr Frank Porreca is Professor of worked at Ruprecht Psychiatry and Pharmacology and -Karls-University, Pharmacology at Anesthesiology at Heidelberg since Dalhousie University, the University of PLUS 2000 and is Halifax,NS,Canada. Arizona College of Pre-Conference Workshops Scientific Director She has 25 years of Medicine, Tucson, Extensive Industry Exhibition of Cognitive and clinician experience AZ. Dr Porreca is Welcome Reception Clinical Neuroscience, assisting patients widely published in Conference Gala Dinner Central Institute of with chronic pain. research addressing Mental Health,Mannheim,Germany. Her research Dr Lynch chaired the Canadian Pain Society Wait mechanisms of chronic pain and its treatment, focuses on neuronal plasticity and learning and Times Task Force and co-chaired its Task Force on and the adaptive nature of brain pain memory in chronic pain,anxiety & mood disorders, Service Delivery and Canadian Pain Strategy. Her modulatory circuits following injury. Dr Porreca’s Managing Pain: substance abuse and neuro-psychological research focuses on new agents in neuropathic current research interests include exploration of rehabilitation. She has received 60+ research pain treatment,including cannabinoids,integrative the intersection between pain and reward from Mechanism grants and numerous prestigious awards and care in chronic pain management, wait-times pathways and discovery of molecules that can to Policy has authored more than 400 publications. benchmarks and strategies for service delivery. modulate these circuits for pain relief.
APS NEWSLETTER I DECEMBER 2014 19 www.nzps2015.org.nz
25 – 29 March, 2015 THE LANGHAM HOTEL, AUCKLAND, NEW ZEALAND
PAIN THROUGH THE AGES
Save the Date: 30 March 2015
http://painadelaide.org/category/painadelaide Speakers include: Bob Coghill | Pe- ter O’Sullivan | Johan Vlaeyen | Glen King | Stuart Brierly | David Butler | Some surprises!
APS NEWSLETTER I DECEMBER 2014 FYI & NEW MEMBERS
Items of interest for our members: complete the relevant survey, links Congratulations to the WA teams below. behind the painHEALTH website. Consumers Survey: https://www. They have just won the WA Health • latest research.net/s/paincons 2014 Empowering Patients award: issue, available online at http:// Clinicians Survey: https://www. http://www.health.wa.gov.au/ www.painaustralia.org.au/media- research.net/s/paincl wahealthawards/winners/index. news/e-news.html cfm#Empowering • • See our blog for the latest video • press conference and two new Article from John Hopkins Maga- For more information about eP- videos clips released in Octo- zine, Fall 2014: POC, refer to the website: http:// ber 2014: http://blog.apsoc.org. http://hub.jhu.edu/magazine/2014/ ahsri.uow.edu.au/eppoc/index. au/2014/10/07/brainman-is-back/ fall/treating-pain-problems html • - • The University of Notre Dame, The latest addition to the fabulous Fremantle Campus, WA is seeking resources developed by the ACI an acclaimed medical specialist Pain Management Network. There for this new role. Application close is also a SCI Navigator, which 08 December 2014: is a clinician decision support www.apsoc.org.au http://www.nd.edu.au/__data/ evidence: www.aci.health.nsw.gov. 11-04-Churack_Chair_Pain_Medi- au/chronic-pain/spinal-cord-injury cine-0-5-Final_PTFINAL.pdf Online Membership • • Applications Please take a few minutes to
NEW MEMBERS NEW apply online here Title First Name Surname Discipline Group Mrs Joanne Blair Nursing Mrs Jane Chalmers Physiotherapy Mrs Natalie Goodman Nursing The next stage of Mr Marty Kelly Physiotherapy our new online Dr Andy Kuo Science Research membership system Mr Stephen Lam Physiotherapy has been launched. Miss Denise Tam Pharmacology Please encourage Dr Hilarie Tardif Psychology your colleagues to Dr Irina Vetter Pharmacology Miss Dawn Wong Lit Wan Science Research apply online here.
APS NEWSLETTER I DECEMBER 2014 21 MEMBERSHIP RENEWAL & CALENDAR OF EVENTS
APS Membership for www.apsoc.org.au Renewals Renewal notices for 2015 were sent 2015 by email to members in late November. Login here!
Before renewing online, please ensure you Payments can be made by Credit Card or Cheque. Login here and renew online via the APS Website.
3-5 Dec 2014 16-17 Jan 2015 22-24 Jan 2015 Australian Pain Management Centre for Pain Medicine at the Asian and Oceanic Society of Association and Palliative Care Swiss Paraplegic Centre Regional Anesthesia and Pain Queensland 5th International Symposium Medicine Congress 2015 Fifty Shades of Pain: Managing Invasive Procedures in Motion 2015 Perioperative Quality and Safety in complex pain across the continuum - Minimal Invasive Pain Therapy Anesthesia and Pain Medicine: Unity Southbank Institute of Technology, Swiss Paraplegic Centre, Nottwil by in Diversity Brisbane QLD Lucerne Switzerland Centara Grand at Central Plaza http://50shadesconference2014.com.au http://www.schmerz-nottwil.ch/en/pub/ Ladprao, Bangkok Thailand zsm/fortbildungkongresse/invasives_ http://www.aosra2015.com/index.php procedures_motion_15.htm
19-20 Feb 2015 21-27 Feb 2015 5 Mar 2015 informa 6th Annual National Breathworks The Children’s Hospital at Dementia Congress Mindfulness Teacher Training Westmead 11th Annual 6th Annual National Dementia Vijayaloka Retreat Centre, Minto Paediatric Pallliative Care Congress Heights, Sydney NSW Symposium Sheraton Hotel, Melbourne VIC http://www.breathworks-mindfulness.org. Updates, Elder, Wisdom, CAM, uk/training-australia-2015 http://www.informa.com.au/ Mindfulness conferences/health-care-conference/ Lorimer Dods Lecture Theatre at national-dementia-congress?utm_ The Children’s Hospital, Westmead, Sydney NSW medium=PDF&utm_ http://www.schn.health.nsw.gov.au/ campaign=P15A03 draft_19th_september_2014_3.pdf
APS NEWSLETTER I DECEMBER 2014 22 CALENDAR OF EVENTS
6 Mar 2015 15-18 Mar 2015 22-23 Mar 2015 The Children’s Hospital at Australian Pain Society 35th Bangladesh Society for Study of Westmead Annual Scientific Meeting Pain Mindfulness for Clinicians Workshop Managing Pain: From Mechanisms Doreen Dew Lecture Theatre at to Policy TBA, Dhaka Bangladesh The Children’s Hospital, Westmead, Brisbane Convention and Exhibition [email protected] Sydney NSW Centre, Brisbane QLD http://www.schn.health.nsw.gov.au/ http://www.dcconferences.com.au/ aps2015/ workshop_colour_brochure_310.pdf
25-29 Mar 2015 30 Mar 2014 29 Apr - 2 May 2015 New Zealand Pain Society 40th PainAdelaide Stakeholders’ NWAC World Anesthesia Annual Scientific Meeting Consortium Convention Pain through the Ages PainAdelaide 2015 6th NWAC 2015 The Langham Hotel, Auckland New Adelaide Convention Centre, Vancouver Convention Centre, Zealand Adelaide SA Vancouver Canada http://www.nzps2015.org.nz http://painadelaide.org/2014/07/03/ http://www.nwac.org painadelaide-2015-register
1 May 2015 2-5 May 2015 24-27 May 2015 Faculty of Pain Medicine (FPM) Australian and New Zealand National Rural Health Alliance Refresher Course Day College of Anaesthetists 13th National Rural Health National Wine Centre, Adelaide SA (ANZCA) Annual Scientific Conference www.fpm.anzca.edu.au/events/2015- Meeting 2015 People, Places, Possibilities refresher-course-day The Changing Face of Anaesthesia Darwin Convention Centre, Darwin and Pain Medicine NT Adelaide Convention Centre, http://ruralhealth.org.au/13nrhc/ Adelaide SA http://asm.anzca.edu.au
31 May - 4 Jun 2015 6-11 Jun 2015 13-14 Aug 2015 IASP Pain in Childhood SIG INS International Drug and Alcohol Nurses of and Seattle Children’s Hospital Neuromodulation Society 12th Australasia - DANA Research Foundation World Congress Many Faces of Addiction Forum 10th International Symposium on Neuromodulation - Medicine 2015 Pediatric Pain Evolving Through Technology Novotel Sydney Central, Sydney TBA, Seattle Washington USA Fairmont Queen Elizabeth Hotel, NSW http://www.ispp2015.com Montreal Quebec, Canada http://danaconference.com.au http://www.neuromodulation.com/ins- congress
APS NEWSLETTER I DECEMBER 2014 23 APS DIRECTORS & OFFICE BEARERS 2014
Directors: Office Bearers :
President: QLD Director: Immediate Past President: Dr Malcolm Hogg Ms Trudy Maunsell Dr Tim Semple Department of Anaesthesia and Pain Princess Alexandra Hospital Royal Adelaide Hospital Pain Clinic Management 199 Ipswich Road North Terrace Royal Melbourne Hospital, Woolloongabba QLD 4102 Adelaide SA 5000 Parkville VIC 3052 Tel: 03 9342 7540 Tel: 07 3176 5547 Fax: 07 3176 5102 Tel: 08 8222 5403 Fax: 08 8222 5904 Fax: 03 9342 8623
President-Elect: SA Director: SPC Chair: Dr Geoffrey Speldewinde Ms Anne Burke Professor Michele Sterling Capital Rehabilitation Multidisciplinary Royal Adelaide Hospital Pain Clinic Injury & Pain Management Centre North Terrace 25 Napier Close Adelaide SA 5000 Parklands Drive Deakin ACT 2600 Tel: 08 8222 4770 Fax: 08 8222 5904 Southport QLD 4222 Tel: 02 6282 6240 Fax: 02 6282 5510 Tel: 07 5678 0368
Secretary: TAS Director IASP Liaison: Mr Michael Deen Mr Simon Watt Professor Michael Nicholas Metro South Persistent Pain Management Physiotherapy - Outpatients Pain Management Research Institute Service North West Regional Hospital Royal North Shore Hospital Level 3, 57 Sanders Street 23 Brickport Road St Leonards NSW 2065 Upper Mount Gravatt QLD 4122 Burnie TAS 7320 Tel: 02 9926 7894 Fax: 02 9662 6279 Tel: 07 3339 5500 Fax: 07 3339 5599 Tel: 03 6430 6608 Fax: 03 6430 6607 Website: www.iasp–pain.org
Treasurer: VIC Director: Website/Social Media Coordinator: Dr Gavin Chin Dr Richard Sullivan Dr Richard Sullivan Royal Darwin Hospital Precision Brain, Spine and Pain Clinic Precision Brain, Spine and Pain Clinic PO Box 41326, Casuarina NT 0811 Lower Ground, 115 Cotham Road Lower Ground, 115 Cotham Road Tel: 08 8922 8888 Fax: 08 8922 8900 Kew VIC 3101 Kew VIC 3101 Tel: 1300 773 247 Fax: 03 9816 8564 Tel: 1300 773 247 Fax: 03 9816 8564
ACT Director: WA Director: Newsletter Editor: Mrs Joy Burdack Dr Stephanie Davies Dr William Howard Calvery Health Care ACT Anaesthetic Department and Pain Department of Anaesthesia PO Box 254 Medicine Unit Austin Health Jamison Centre ACT 2614 Fremantle Hospital Health Service Studley Road, Heidelberg VIC 3084 Tel: 02 6201 6854 Fax: 02 6201 6949 Alma St, Perth WA 6160 Tel: 03 9496 3800 Fax: 03 9459 6421 Tel: 08 9431 3296 Fax: 08 9431 3696
NSW Director: PhD Scholarship Chair: Ms Fiona Hodson Professor Maree Smith Hunter Integrated Pain Service Centre for Integrated Preclinical Drug John Hunter Hospital and Royal Development Newcastle Centre PO Box 664J University of Queensland Newcastle NSW 2300 St Lucia QLD 4072 Tel: 02 4922 3435 Fax: 02 4922 3438 Tel: 07 3365 2554 Fax: 07 3365 1688
NT Director: Secretariat: Ms Jenny Phillips DC Conferences Pty Ltd Acute Pain Service, Royal Darwin PO Box 637, North Sydney, NSW 2059 Hospital Tel: 02 9016 4343 Fax: 02 9954 0666 PO Box 41326, Casuarina NT 0811 Email: [email protected] Tel: 08 8922 8888 Fax: 08 8922 8325
APS NEWSLETTER I DECEMBER 2014