Clinical Issues in Chronic Pain
Consensus and Controversies for Responsible Opioid Prescribing
Meeting Slides
Clinical Tools
Brief Pain Inventory (Short Form)
A multidimensional pain assessment instrument that can be used to characterize several aspects of a patient’s pain experience, the short form is also widely used for clinical trials and has been translated into multiple languages.
Opioid Risk Tool
This five-question clinical interview or patient questionnaire helps stratify patients based on their risk for opioid-related misuse and abuse.
Current Opioid Misuse Measure (COMM)®
A 17-item assessment questionnaire, the COMM focuses on current behaviors and cognition rather than character and personality traits associated with risks for substance abuse.
Pain Assessment and Documentation Tool (PADT™)
Completed via clinician-directed interview, this instrument provides a consistent and structured method to document progress with opioid therapy over time.
Guidelines
American Pain Society and American Academy of Pain Medicine: Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain
Chou R, Fanciullo GJ, Fine PG, et al. J Pain. 2009;10(2):113-130.
Department of Veterans Affairs and Department of Defense: Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain
The Management of Opioid Therapy for Chronic Pain Working Group. Washington, DC: Department of Veterans Affairs, Department of Defense; 2010.
Other Resources
A Clinical Guide to Opioid Analgesia. 2nd edition
Fine PG, Portenoy RK. New York, NY: Vendome Group, LLC; 2007.
Responsible Opioid Prescribing: A Clinician’s Guide. 2nd edition, revised and expanded
Fishman SM. Washington, DC: Waterford Life Sciences; 2012.
Suggested Readings
Abuse rates and routes of administration of reformulated extended-release oxycodone: initial findings from a sentinel surveillance sample of individuals assessed for substance abuse treatment
Butler SF, Cassidy TA, Chilcoat H, et al. J Pain. 2013;14(4):351-358.
Establishing "best practices" for opioid rotation: conclusions of an expert panel
Fine PG, Portenoy RK; Ad Hoc Expert Panel on Evidence Review and Guidelines for Opioid Rotation. J Pain Symptom Manage. 2009;38(3):418-425.
Universal precautions in pain medicine: a rational approach to the treatment of chronic pain
Gourlay DL, Heit HA, Almahrezi A. Pain Med. 2005;6(2):107-112.
Urine drug testing in pain medicine
Heit HA, Gourlay DL. J Pain Symptom Manage. 2004;27(3):260-267.
Substance misuse treatment for high-risk chronic pain patients on opioid therapy: a randomized trial
Jamison RN, Ross EL, Michna E, et al. Pain. 2010;150(3):390-400.
Assessment and treatment of abuse risk in opioid prescribing for chronic pain
Jamison RN, Serraillier J, Michna E. Pain Res Treat. 2011;2011:941808.
Rates of opioid dispensing and overdose after introduction of abuse-deterrent extended-release oxycodone and withdrawal of propoxyphene
Larochelle MR, Zhang F, Ross-Degnan D, Wharam JF. JAMA Intern Med. 2015;175(6):978-987
Abuse-deterrent formulations: part 2: commercial products and proprietary technologies
Mastropietro DJ, Omidian H. Expert Opin Pharmacother. 2015;16(3):305-323.
A review of abuse-deterrent opioids for chronic nonmalignant pain
Moorman-Li R, Motycka CA, Inge LD, et al. P T. 2012;37(7):412-418.
Abuse-deterrent formulations, an evolving technology against the abuse and misuse of opioid analgesics
Schaeffer T. J Med Toxicol. 2012;8(4):400-407.
Consensus and Controversies for Responsible Opioid Prescribing
Relevant Resources
Balancing the Benefits and Risk of Opioid-Based Therapy
Individualized Assessment and Mechanism-Based Multimodal Treatment
Responsible Opioid Prescribing to Achieve Individualized Functional Goals
Overcoming Pain and Gastrointestinal Distress to Improve Patient Outcomes
Proactive Diagnosis and Targeted Management
Selecting Patients and Optimizing Long-Term Outcomes
Evidence-Based Strategies for Improved Patient Outcomes
Proactive Diagnosis and Targeted Management
Differential Diagnosis and Comprehensive Management Strategies
Optimizing Maintenance Therapy Across Healthcare Settings
Evolving Strategies for Diagnosis and Long-Term Management
Best Practices in Combination Therapy
The Role of Nurses in Optimizing Long-term Outcomes
Evolving Approaches to Insulin Based Therapy
Evolving Best-Practice Strategies to Maximize Efficacy and Safety
Improving Outcomes for Patients with COPD
New Strategies for Insulin Replacement Therapy
Clinical Updates in LDL-C Management
Improving Comprehensive Patient Care
Identifying Patients and Tailoring Therapy
Collaborative Approaches to Guideline-Concordant Patient Care
New Strategies for Individualizing Long-term Care
A Focus on Patients With Opioid-Induced Constipation
Consensus and Controversies Across the Spectrum of Patient Presentations
Evolving Treatment Algorithms and Expert Perspectives on Biosimilars
Patient Selection, Treatment Initiation, and Ongoing Monitoring
Engaging With Patients About Opioid-Induced Constipation
Evolving Best Practices to Optimize Outcomes
The PCP’s Role in Timely Recognition and Referral
Debates and Discussions About Therapeutically Targeting Nerve Growth Factor Signaling
Differential Diagnosis, Multidisciplinary Management, and Patient Engagement
Key Issues Impacting OB/GYN Practice
Expanding the Conversation on Opioid-Induced Constipation
Volume II: Expanding Evidence for the Role of Rapid ART Initiation in HIV Practice
Translating Guidelines Into Patient Care
Improving Patient Outcomes Through Shared Clinical Decision Making
Mechanistic Insights and Evolving Treatment Options
Clinical Resource Center
A Case-Based Conversation on Managing Asthma and Chronic Rhinosinusitis With Nasal Polyposis
The Clinical and Utilization Benefits of Exacerbation Prevention
A PrEP Primer
A Foundation for Managed Care
Cardiovascular and Renal Outcomes With SGLT2 Inhibitors
Best Practices for Primary Care
New Paths to Chronic Pain Management
What the Pharmacist Needs to Know about PrEP
Unlocking Novel Paths to Patient Care
The Increasing Role of JAK Inhibitors
Preventing COPD Exacerbations to Improve Outcomes
A Whole Patient Case Series
Getting on the Fast Track to Identify AxSpA
Establishing Clinical Readiness Through Mentored Learning
Interdisciplinary Strategies for Adult and Pediatric Patients
Interdisciplinary Management of Eosinophilic Esophagitis and Hereditary Angioedema
Reducing LDL-C and a Lifetime of Cardiovascular Risk
Updates, Clinical Scenarios, and Future Directions
A Multidisciplinary Look at Early Diagnosis and Management
Best Practices for Diagnosis and Management
An Update on Best Practices
New Avenues to Pre-Exposure Prophylaxis
Are You Aware of New Blood-Based Multi-Cancer Screening Tools
A Look at the Changing HIV Playing Field
A “How To” Series Spanning Policy to Practice
Test Your Mastery!
Building Bridges to Reach People who Inject Drugs with the Goal of Employing PrEP for HIV Prevention
Strengthening Your Knowledge of Blood-Based Screening Tools
Bringing HIV Prevention to a New Level
Optimizing HIV Prevention in Primary Care
