October 06, 2016

Vet Technicians Can Play Vital Role In Improving Pain Control

Behavioral model reveals subconscious beliefs that restrict good pain management
By Erin White
Bradbury and Malik used the COM-B behavioural model (see Figure), which provides an objective framework, to assess the underlying drivers behind the use of analgesics at veterinary practices.
The model, which is more frequently applied in human medicine, suggests that three conditions are essential for a person to perform a specific behaviour: capability, opportunity and motivation.
Bradbury continues: “Although veterinary technicians are not able to prescribe drugs directly, they can have a positive effect with deliberate interventions that increase the likelihood of veterinary surgeons prescribing analgesics, either consciously or subconsciously.
“The COM-B framework drew together the conscious and subconscious barriers to good pain management.”
Consciously, vets were worried about potential side effects, that the drugs would mask the symptoms, and that the cost of the drugs would be unacceptable to the owner. Vets often overestimated these risks while underestimating the benefit that the animal would receive from the treatment. Subconsciously, ‘species prejudice,’ where a moral status (pet, pest, food) is given to an animal, influences the empathy of vets and therefore their administration of pain relief.
By using the model Bradbury and Malik were able to objectively analyze the situation in the veterinary clinic and to identify where there were opportunities for interventions to positively affect behavior. As the role of veterinary technician may vary between countries, this can also apply to other para-veterinary staff who cannot prescribe pain relief.
Recommendations included: organizing education in pain management; guiding practice policy on pain assessment and routine analgesic use; creating a compassionate clinical environment; and encouraging two-way communication on pain assessment. These measures can help practices to implement the new AAHA/AAFP guidelines.
Although there might be subtle cultural differences between the United States and Europe, Bradbury believes that there is not enough applicable research, at this point in time, to construct a model based only on work published in just one country:
“Our paper uses references from North America, the UK, New Zealand and more, placing it at a higher level than should be affected by local variations.” 
Bradbury suggests that behavioral science could be used to support other areas within veterinary practice, such as strengthening the relationship with clients and communicating more effectively to improve animal welfare.
She says: “The medical world is now beginning to embrace behavioural science to improve physician performance and patient outcomes, and where the medical world leads, the veterinary world is not far behind. I look forward to the application of behavioural science in many areas of veterinary practice.”
See link to paper: http://dx.doi.org/10.1080/17415349.2016.1153989

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