Management of chronic noncancer pain in the primary care setting.

Publication/Presentation Date

10-1-2007

Abstract

While opioids are regarded as the mainstay of chronic pain management, their use is controversial in the minds of many primary care physicians due to clinical concerns about dependence, abuse, and addiction and medicolegal concerns regarding state and federal regulatory authorities. For patients with moderate to moderately severe pain, the treatment of choice is a long-acting opioid or opioid combination drug product to provide sustained analgesia along with improvements in sleep quality, compliance, and possibly quality of life. Careful screening of patients being considered for long-term opioid therapy with validated questionnaires can identify patients who may have difficulties in managing opioids. These patients should not be denied access to opioid therapy, but they do require focused monitoring and case management. Ongoing monitoring should focus on the 4 A's (ie, analgesia, activities of daily living, adverse effects, and aberrant drug-related behaviors), and all aspects of patient care must be thoroughly documented.

Volume

100

Issue

10

First Page

1028

Last Page

1036

ISSN

0038-4348

Disciplines

Medicine and Health Sciences

PubMedID

17943050

Department(s)

Department of Medicine

Document Type

Article

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