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Inadequately managed pain can lead to adverse physical and psychological patient outcomes for individual patients and their families. Continuous, unrelieved pain activates the pituitary-adrenal axis, which can suppress the immune system and result in postsurgical infection and poor wound healing. Sympathetic activation can have negative effects on the cardiovascular, gastrointestinal, and renal systems, predisposing patients to adverse events such as cardiac ischemia and ileus. Of particular importance to nursing care, unrelieved pain reduces patient mobility, resulting in complications such as deep vein thrombosis, pulmonary embolus, and pneumonia. Postsurgical complications related to inadequate pain management negatively affect the patient’s welfare and the hospital performance because of extended lengths of stay and readmissions, both of which increase the cost of care.

Continuous, unrelieved pain also affects the psychological state of the patient and family members. Common psychological responses to pain include anxiety and depression. The inability to escape from pain may create a sense of helplessness and even hopelessness, which may predispose the patient to a more chronic depression. Patients who have experienced inadequate pain management may be reluctant to seek medical care for other health problems.

There is a complete absence of standards of pain management in primary care in Pakistan.




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Eligibility Criteria

Hold a current, active PMDC registration or the professional, Legally‐recognized equivalent in another country.

A minimum of 500 faculty supervised clinical hours in the internal medicine in an advanced pain management role OR 6 month house job in internal medicine from an HEC recognized medical institution.

Experience of at least 4 years of clinical practice as a family physician where the doctor may be involved in the care of patients.

Associate membership of College of Family Medicine Pakistan


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