Module A: Determining Appropriateness for Opioid Therapy
Has the Patient been on daily opioid therapy longer than the past 3 months (i.e. chronic opioid therapy)?
Obtain a Biopsychosocial Assessment. The components are listed below.
- Pain assessment including history, physical exam, co-morbidities, previous treatment and medications, duration of symptoms, onset and triggers, location/radiation, previous episodes, intensity and impact, patient perception of symptoms.
- Functional goals.
- Impact of pain on family, work, and life.
- Review of previous diagnostic studies.
- Additional consultations and referrals.
- Coexisting illness and treatments and effect on pain.
- Significant psychological, social, or behavioral factors that may affect treatment.
- Family history of chronic pain.
- Collateral of family involvement.
- Patient's beliefs or knowledge of: 1) cause of pain; 2) treatment preferences; 3) perceived efficacy of various treatment options.
- For patients already on opioid therapy, include assessment of psychological factors (e.g., beliefs, expectations, fears) related to continuing versus tapering opioid therapy.
Educate or re-educate patient on:
- Non-opioid management
- Self-management to improve function and quality of life
- Realistic expectations and limitations of medical treatment
Implement and optimize non-opioid treatments for chronic pain (e.g., physical, psychological, and complementary and integrative treatments).