By Linda Satter 

Aug. 14, 2023 | A $1.5 million grant from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) will allow the University of Arkansas for Medical Sciences (UAMS) Department of Emergency Medicine to revolutionize the ways in which it treats pain and trains new doctors.

The award funds a three-year project to train UAMS emergency physicians, advanced practice providers and nurses about pain management strategies that treat pain aggressively but don’t rely on opioid medications.

Michael Wilson, M.D., Ph.D., an associate professor in the UAMS College of Medicine departments of Emergency Medicine and Psychiatry, said he expects the project to lead to better pain management throughout Arkansas.

“We believe that training providers on how to treat pain more effectively, but without using opioids, will not only help current UAMS patients, but will also help the rest of the state for years to come,” Wilson said.

Wilson is the co-primary investigator with Carly Eastin, M.D., an associate professor in the UAMS Departments of Emergency Medicine and Pediatrics, who added, “This is because approximately 45% of UAMS emergency medicine residents remain in Arkansas after graduation, and the majority of emergency department physicians currently working in Arkansas were trained at UAMS.”

The project is called “Improving Emergency Department Management of Acute and Chronic Pain Using Non-Opioid Strategies.”

“We are also hopeful,” Wilson said, “that the UAMS Department of Emergency Medicine can serve as a statewide model for successful pain management without opioids, since Arkansas has had the second-highest opioid prescribing rate in the nation since the early 2010s.”

In 2016, Arkansas physicians prescribed 114.6 opioid prescriptions for every 100 people. While the number declined to 75.8 prescriptions for every 100 people by 2020, the rate remains 75% higher than the national average of 43.3 prescriptions for every 100 people, he said.

The project aims to improve pain relief but reduce the use of opioids through three initiatives: provider education and electronic medical record optimization, using peer navigators to help patients manage pain without opioids and, for patients whose use of opioids is either ineffective or hazardous, implementing interventional pain procedures such as acupuncture and nerve blocks.

“The impact of these initiatives will be profound,” Wilson predicted. “We estimate that we will be able to affect care for more than 8,000 patients each year who come to the emergency department with painful conditions. We hope the program will become a statewide model for aggressive pain management without opioids.”

UAMS is the state’s only academic medical center and has the largest residency training program in emergency medicine, which serves more than 65,000 patients annually. On average, 11,000 patients each year come to the UAMS emergency department complaining of pain.

A predominantly rural state, Arkansas has the sixth-highest poverty rate in the nation, and many patients have poor access to treatment providers and facilities. It ranks among the top 10% of states whose patients need treatment for opioid use disorder.

This study is supported by grant 1H79TI086020-01, issued through the U.S. Department of Health and Human Services (HSS)’ Substance Abuse and Mental Health Services Administration (SAMHSA).UAMS is the state’s only health sciences university, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; a hospital; a main campus in Little Rock; a Northwest Arkansas regional campus in Fayetteville; a statewide network of regional campuses; and seven institutes: the Winthrop P. Rockefeller Cancer Institute, Jackson T. Stephens Spine & Neurosciences Institute, Harvey & Bernice Jones Eye Institute, Psychiatric Research Institute, Donald W. Reynolds Institute on Aging, Translational Research Institute and Institute for Digital Health & Innovation. UAMS includes UAMS Health, a statewide health system that encompasses all of UAMS’ clinical enterprise. UAMS is the only adult Level 1 trauma center in the state. UAMS has 3,240 students, 913 medical residents and fellows, and five dental residents. It is the state’s largest public employer with more than 11,000 employees, including 1,200 physicians who provide care to patients at UAMS, its regional campuses, Arkansas Children’s, the VA Medical Center and Baptist Health. Visit www.uams.edu or uamshealth.com. Find us on Facebook, Twitter, YouTube or Instagram.

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Red Sash Awards

Dr. Marc Phan was selected as a Red Sash Award winner at the College of Medicine Honors Convocation. The award is given to faculty members recognized by members of the senior class as among the most outstanding teachers during their four years in medical school.

Deans Honor Day

Physician of the Year
Randy Maddox, M.D.
Professor, Department of Emergency Medicine
Director, Emergency Medicine Service Line

Collaborations and Teamwork
Zachary Lewis, M.D.
Assistant Professor (Associate Professor as of July 1)
Department of Emergency Medicine
Ultrasound Director, Emergency Medicine Residency Program

Read the article on the UAMS News website for details.

Mehta Creative Writing Awards

Our resident Beth Hanson was the Creative Nonfiction Award Winner for her work “The Window.”

Read the article on the UAMS News website for details.

Chancellor’s Teaching Award

Gregory Snead, M.D., Professor and Vice Chair of Emergency Medicine, received the Chancellor’s Teaching Award for Teaching Excellence at the UAMS Commencement ceremony.

In 2016, the Women’s Foundation of Arkansas presented the inaugural First Lady’s Woman in Public Service award. WFA established the award in partnership with Arkansas First Lady Susan Hutchinson to celebrate and acknowledge a woman who is committed to empowering and inspiring women and girls through a career in public service.

The 2021 awardee is our own Dr. Jerrilyn Jones. Read more about the award on the WFA website. Dr. Jones will be honored at the Power of the Purse event on September 22.

By Linda Satter 

An idea for increasing COVID-19 vaccination rates in Arkansas while providing an educational experience for University of Arkansas for Medical Science (UAMS) students has proven successful on both fronts.

It all started with Travis Eastin, M.D., and wife Carly Eastin, M.D., both associate professors in the College of Medicine’s Department of Emergency Medicine, who saw an opportunity to enlist students to help educate unvaccinated patients about COVID-19 vaccines.

The timing couldn’t have been better. A year and a half into the pandemic, Arkansas is making national headlines over its simultaneous surge in new COVID-19 cases while an estimated two-thirds of residents remain unvaccinated. The Eastins knew that every effort to increase vaccinations was needed.

“We started by doing a needs assessment using Emergency Medicine Interest Group students just asking patients if they’d like to be vaccinated during their Emergency Department (ED) visit if it was available, and enough said yes that we just moved to actually administering the shots,” Carly Eastin said. “We are trying to get as many students mobilized to assist with approaching patients, educating them, offering the vaccine and then ordering it and facilitating giving it for those who accept.”

Emergency medicine resident Brendan Moore, M.D., and fourth-year medical student Morgan Sweere Treece, helped the Eastins put out the call for volunteers among students in the emergency medicine group. Later they expanded the request for volunteers to pharmacy students and then all medical students.

“The primary goal is to increase the number of vaccinated Arkansans, and while there is a survey and we are tracking data, the main objective is vaccination,” said Travis Eastin, shortly after the request for volunteers was posted on student listservs.

Less than two weeks later, Carly Eastin reported, “We feel that so far this has been a huge success! We have had volunteer medical students for mostly four hours – sometimes eight hours a day – each weekday since the end of June.”

She said students approach patients whose charts indicate they aren’t vaccinated, offer information about vaccine safety and efficacy, and answer questions the patients may have. The medical students then offer the vaccine. If the patient accepts, the student alerts the patient’s bedside nurse.

She later reported, “In about three weeks, we have offered the vaccine to 152 patients. Of those, the students have assisted in administering 38 vaccines in the ED and have helped schedule 15 others to receive their vaccines in a vaccine clinic.”

The response to the students’ efforts prompted ED providers to offer the vaccines during all shifts, including nights and weekends. By July 21, 61 COVID vaccines had been administered, and another 15 patients had made appointments to get them later.

“There is certainly a mix of reactions, in my experience,” said Fuad “Kikko” Haydar, MBA, who is working toward obtaining a medical degree in 2024 and who has been one of the most active volunteers.

“Some people are very happy to be able to conveniently get vaccinated in the ED,” he said. “Some don’t even want to discuss it. Some have asked questions about safety and side effects, and we were able to give them enough information to alleviate their worry. And then there are some who are upset when we bring up the vaccine entirely.”

The ED patients are being offered the one-dose Johnson & Johnson vaccine or the two-dose Pfizer vaccine. The Johnson & Johnson vaccine is now being stocked in the Emergency Department and is available around the clock.

“I would like to give a shout-out to Pharmacy Specialist Gavin Jones, Pharmacy Director Sherry Myatt and Melissa Jo Easdon, nursing director in the Emergency Department, for helping make this a success,” Carly Eastin said.

Recent statistics show that 60% of Arkansans who are 12 and older aren’t fully vaccinated, yet people are increasingly going out in public and attending large events without masks and without practicing social distancing.

“The best solution is rapid, immediate vaccination of every eligible Arkansans,” UAMS Chancellor Cam Petterson, M.D., MBA, said July 14.

While UAMS is seeing a new influx of patients hospitalized with COVID-19, Patterson has emphasized that vaccines do work, noting that none of the vaccinated patients at the hospital have died.