Opioid therapy for chronic pain: Difference between revisions
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(/* Recommendations for patients with chronic pain (DO NOT EDIT) {{cite web |url=http://www.guideline.gov/content.aspx?id=16313&search=opioid+therapy+guidelines |title=National Guideline Clearinghouse | VA/DoD clinical practice guideline for m...) |
(/* Recommendations for patients with chronic pain (DO NOT EDIT) {{cite web |url=http://www.guideline.gov/content.aspx?id=16313&search=opioid+therapy+guidelines |title=National Guideline Clearinghouse | VA/DoD clinical practice guideline for m...) |
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| colspan="1" style="text-align:center; background:LightGreen"|'''Obtain Comprehensive Assessment Including: History, Physical Examination, and a Review of Diagnostic Studies''' | | colspan="1" style="text-align:center; background:LightGreen"|'''Obtain Comprehensive Assessment Including: History, Physical Examination, and a Review of Diagnostic Studies''' | ||
'''1''' A comprehensive patient assessment should be completed to identify clinical conditions that may interfere with the appropriate and safe use of OT. The comprehensive assessment should include: | '''1''' A comprehensive patient assessment should be completed to identify clinical conditions that may interfere with the appropriate and safe use of OT. The comprehensive assessment should include: | ||
'''Medical history''' | (a) '''Medical history''' | ||
* Age, sex | * Age, sex | ||
* History of present illness, including a complete pain assessment (see Annotation C below) | * History of present illness, including a complete pain assessment (see Annotation C below) | ||
Line 30: | Line 30: | ||
* Medications (including current and past analgesics, their effectiveness, side effects, and tolerability, as well as drugs that may interact with OT) | * Medications (including current and past analgesics, their effectiveness, side effects, and tolerability, as well as drugs that may interact with OT) | ||
* Substance use history (personal, family, peer group) | * Substance use history (personal, family, peer group) | ||
* Family history | |||
* Social history (including employment, cultural background, social network, marital history, and legal history, other behavioral patterns [i.e., impulse behaviors]) | * Social history (including employment, cultural background, social network, marital history, and legal history, other behavioral patterns [i.e., impulse behaviors]) | ||
* Review of systems | |||
* Allergies | * Allergies | ||
* Abuse (sexual, physical, and mental) | * Abuse (sexual, physical, and mental) | ||
'''Physical examination''' | '''Physical examination''' | ||
* A general examination | * A general examination |
Revision as of 11:45, 28 November 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Management of Opioid Therapy for Chronic Pain Working Group. VA/DoD clinical practice guideline for management of opioid therapy for chronic pain. Washington (DC): Department of Veterans Affairs, Department of Defense (DO NOT EDIT) [1]
Recommendations for patients with chronic pain (DO NOT EDIT) [1]
Assessment of patient |
"1. A trial of opioid therapy (OT) is indicated for a patient with chronic pain who meets all of the following criteria:
" |
"2. The ethical imperative is to provide the pain treatment with the best benefit-to-harm profile for the individual patient." |
Obtain Comprehensive Assessment Including: History, Physical Examination, and a Review of Diagnostic Studies
1 A comprehensive patient assessment should be completed to identify clinical conditions that may interfere with the appropriate and safe use of OT. The comprehensive assessment should include: (a) Medical history
Physical examination
Information from the pain history and physical exam should be reviewed to ensure that the patient has had an adequate therapeutic trial of non-opioid medication therapies.
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