scholarly journals Provider confidence in opioid prescribing and chronic pain management: results of the Opioid Therapy Provider Survey

2017 ◽  
Vol Volume 10 ◽  
pp. 1395-1400 ◽  
Author(s):  
Amy Pearson ◽  
Rajat Moman ◽  
Susan Moeschler ◽  
Jason Eldrige ◽  
W. Michael Hooten
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Opioid Therapy ◽  
Chronic Pain Management ◽  
Opioid Prescribing ◽  
Provider Survey

scholarly journals Blood Testing in Chronic Pain Management

2015 ◽  
Vol 2;18 (2;3) ◽  
pp. E157-E161
Author(s):  
Timothy R. Deer
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Patient Compliance ◽  
Drug Testing ◽  
Opioid Therapy ◽  
Current Evidence ◽  
Opioid Tolerance ◽  
Opioid Overdose ◽  
Chronic Pain Management ◽  
Blood Testing

Blood testing is quickly becoming a useful laboratory tool for opioid prescribers who wish to document and assess patient tolerance, more objectively monitor patient safety, and evaluate patient compliance using information that is not available with traditional urine drug testing (UDT). Blood testing does not need to be performed as frequently as UDT but provides extremely valuable information which can be used to more accurately evaluate patient compliance and assist with interpreting blood toxicology results commonly used in impairment or overdose cases. This narrative review presents the current evidence supporting the use of blood testing within the chronic pain management setting. In addition, this review aims to introduce and discuss the role of routine blood testing within the chronic pain management setting. Blood testing for the purpose of documenting opioid tolerance is a relatively novel tool for pain physicians and as such this review is not intended to be a comprehensive or exhaustive review of the scientific or medical literature. Prescribers must also be aware that this type of laboratory testing need only be administered to chronic pain patients receiving daily opioid therapy. Patients taking infrequent, low dose, or as needed medications are not anticipated to benefit from this type of test. Based on the complexity of both achieving acceptable outcomes with opioid treatment and the legal and societal issues at hand, we feel that the addition of blood concentration levels will become the standard of care in the near future. Key words: Chronic pain, blood testing, opioids, opioid tolerance, patient compliance, opioid overdose

scholarly journals Prescribers or Multidisciplinarians? An Evaluation of Brief Education for General Practitioners on Chronic Pain Management

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Simon Mark Holliday ◽  
Chris Hayes ◽  
Lester Edmund Jones ◽  
Jill Gordon ◽  
Catherine Fraser ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Sensitivity Analysis ◽  
Pain Management ◽  
General Practitioners ◽  
Chronic Pain Management ◽  
Primary Analysis ◽  
Opioid Prescribing ◽  
Cohen’S D ◽  
Educational Package ◽  
Post Test

Purpose Active pain self-management (PSM) for patients with chronic pain is assumed to require multidisciplinary care, leaving prescribing analgesics the most accessible option for general practitioners (GPs). We sought to upskill GPs in multimodalPSM with a harm minimisation approach for any opioid prescribing. Design and Methodology Having developed an educational training resource, a multidisciplinary team delivered the program to attendees at a GP conference in 2017. The educational package comprised pre-readings, a 6-hour interactive, skills-based workshop, and post-workshop resources. The single-group intervention was evaluated with an original and unvalidated pre/post-test (three months) survey of four domains: knowledge; attitudes; utilisation of strategies involving PSM and opioid harm minimization. Paired t-tests were conducted on each domain score and overall, with effect sizes assessed with Cohen’s d. A sensitivity analysis was performed on the data lacking a post-test survey response. Post-survey scores were imputed via chained regression equations, then paired t-tests analyses were conducted on imputed datasets using Rubin's method to pool estimates. FindingsOf 99 participants, 33 returned both surveys for primary analysis. These were combined in the sensitivity analysis with 60 unpaired surveys. Internal consistency was modest (Cronbach’s alpha 0.736). Primary analysis demonstrated significant self-reported improvements in each educational domain with overall score increasing 10.54 points out of 130 (p<0.001 Cohen’s d 1.11). Improvements were similar in a sensitivity analysis. Discussion, Limitations and Conclusions This study found that a brief GP educational package may be a viable intervention for facilitating PSM and promoting safer prescribing strategies. Outcomes at three months, from this unvalidated survey instrument, suggest improvements in knowledge, attitudes and self-reported facilitation of PSM and opioid prescribing. As this study did not measure clinician behaviour or patient outcomes objectively, further educational research is indicated to confirm these findings and identify how best to deliver chronic pain management training.

Does brief chronic pain management education change opioid prescribing rates? A pragmatic trial in Australian early-career general practitioners

Pain ◽  
2017 ◽  
Vol 158 (2) ◽  
pp. 278-288 ◽  
Author(s):  
Simon Mark Holliday ◽  
Chris Hayes ◽  
Adrian J. Dunlop ◽  
Simon Morgan ◽  
Amanda Tapley ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
General Practitioners ◽  
Management Education ◽  
Pragmatic Trial ◽  
Early Career ◽  
Chronic Pain Management ◽  
Opioid Prescribing ◽  
Education Change

scholarly journals Framing of the opioid problem in cancer pain management in Canada

2019 ◽  
Vol 26 (3) ◽  
Author(s):  
R. Asthana ◽  
S. Goodall ◽  
J. Lau ◽  
C. Zimmermann ◽  
P. L. Diaz ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Cancer Pain ◽  
Opioid Therapy ◽  
Position Paper ◽  
Chronic Pain Management ◽  
Opioid Use ◽  
Cancer Pain Management ◽  
Canadian Guideline ◽  
Patients With Cancer

Two guidelines about opioid use in chronic pain management were published in 2017: the Canadian Guideline for Opioids for Chronic Non-Cancer Pain and the European Pain Federation position paper on appropriate opioid use in chronic pain management. Though the target populations for the guidelines are the same, their recommendations differ depending on their purpose. The intent of the Canadian guideline is to reduce the incidence of serious adverse effects. Its goal was therefore to set limits on the use of opioids. In contrast, the European Pain Federation position paper is meant to promote safe and appropriate opioid use for chronic pain.     The content of the two guidelines could have unintentional consequences on other populations that receive opioid therapy for symptom management, such as patients with cancer. In this article, we present expert opinion about those chronic pain management guidelines and their impact on patients with cancer diagnoses, especially those with histories of substance use disorder and psychiatric conditions. Though some principles of chronic pain management can be extrapolated, we recommend that guidelines for cancer pain management should be developed using empirical data primarily from patients with cancer who are receiving opioid therapy.

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