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The "Managing Chronic, Non-Cancer Pain" course is divided into five units, offering an evidence-based and multidisciplinary approach to understanding and managing chronic pain.

Unit 1: Introduction to Chronic, Non-Cancer Pain
This foundational unit introduces the definitions, pathophysiology, and impact of chronic pain. Key topics include:

• Categories of pain: nociceptive, neuropathic, and nociplastic
• Chronic pain's prevalence, particularly among older adults, and its effects on mobility, mental health, and social well-being
• The biopsychosocial model for understanding pain and its multifactorial nature.

Unit 2: Comprehensive Pain Assessment
Learn how to conduct thorough and efficient pain assessments despite time constraints. This unit emphasises:

• Gathering pain history, identifying pain type, severity, and functional impact
• Using tools like the Brief Pain Inventory and Geriatric Pain Measure for structured evaluations
• Special considerations for cognitively impaired patients, including behaviour-based assessments and analgesic trials.

Unit 3: Non-Pharmacologic Management
Explore non-drug interventions that form the cornerstone of chronic pain management:

• Physical therapies: physiotherapy, therapeutic exercises, hydrotherapy, and stretching
• Psychological approaches: psycho-education, cognitive-behavioural therapy (CBT), and mindfulness practices
• The role of family and caregivers in supporting pain management and improving patient outcomes.

Unit 4: Pharmacologic Management – Non-Opioids
Delve into the first-line pharmacologic options for chronic pain:

• Medications for nociceptive pain, including acetaminophen and NSAIDs
• Treatments for neuropathic pain, such as antidepressants (e.g., duloxetine, tricyclics) and anticonvulsants (e.g., pregabalin, gabapentin)
• The role of topical and injected analgesics for targeted pain relief, minimising systemic side effects.

Unit 5: Pharmacologic Management – Opioids
Understand the cautious and ethical use of opioids in chronic pain treatment:

• When to consider opioids and how to mitigate risks, including addiction, falls, and cognitive impairment
• Guidelines for selecting opioids like tramadol, tapentadol, or oxycodone and the importance of starting low and titrating carefully
• Deprescribing strategies for non-responders and incorporating functional improvement as a key treatment goal.

This course integrates theoretical knowledge, practical tools, and real-world applications, empowering healthcare providers to deliver holistic, patient-centred care for chronic, non-cancer pain effectively and safely.

Learning Outcomes

1. Determine the prevalence of non-cancer pain in the elderly population and the burden of this problem for both the individual and the community
2. Apply an evidence-based approach to the management of non-cancer pain to optimise safety and quality of life.

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