About
Dr. Silveira is an associate professor in palliative medicine at the University of Michigan and a clinical scientist at the Ann Arbor Veterans Affairs Medical Center (VAMC). Dr. Silveira was moved to become a pioneer in palliative care after witnessing the unaddressed suffering of countless patients during her medical school training in the 1990's. After completing her clinical training, she studied health services research through the Robert Wood Johnson Clinical Scholars Program. Early in her research career, Dr. Silveira conducted observational studies to document the high symptom burden among patients at the end of life, examine the use of advance directives, and demonstrate the relationship between economic status and symptom control. Inspired to improve the lives of the patients Dr. Silveira studied and saw in clinic, she has devoted the last 10 years to developing information technology to support patients with symptoms so that they may access safe and effective symptom management advice, communicate more efficiently and effectively with their clinicians, and involve their family caregivers.
Current Work
Thousands of veterans are prescribed opioids every year to manage pain. Opioids carry significant risks, including side effects, addiction, overdose, and death. Despite this risk, most would agree that in the setting of severe cancer pain, the risk/benefit analysis favors the use of opioids. The question then becomes, "How can we help veterans with cancer pain take their opioids safely?" Dr. Silveira hypothesizes that targeted, clinical pharmacist support for veterans taking opioids for cancer pain can reduce pain severity, opioid-related side effect burden, and the number of moderate to severe adverse events. Their long-term goal is to develop a cost-effective intervention that can be implemented throughout veterans affairs to assist in its ongoing efforts to curb the epidemic of opioid-related morbidity and mortality by providing a mechanism for intensely monitoring and supporting veterans taking opioids.
Research Area Keyword(s)
caregiving, opioids, pain, palliative care, symptom management