Developing a Safe Opioid Treatment Plant for Managing Chronic Pain ________________________________
CONSULTATION AND REFERRAL It is important to seek consultation or patient referral when input or care from a pain, psychiatry, addiction, or mental health specialist is necessary. Clinicians who prescribe opi- oids should become familiar with opioid addiction treatment options (including licensed opioid treatment programs for methadone and office-based opioid treatment for buprenor- phine) if referral is needed [4]. Ideally, providers should be able to refer patients with active substance abuse who require pain treatment to an addiction professional or specialized program [4]. In reality, these spe- cialized resources are scarce or non-existent in many areas. Therefore, each provider will need to decide whether the risks of continuing opioid treatment while a patient is using illicit drugs outweigh the benefits to the patient in terms of pain control and improved function [20]. MEDICAL RECORDS Documentation is a necessary aspect of all patient care, but it is of particular importance when opioid prescribing is involved. All clinicians should maintain accurate, complete, and up- to-date medical records, including all written or telephoned prescription orders for opioid analgesics and other controlled substances, all written instructions to the patient for medica- tion use, and the name, telephone number, and address of the patient’s pharmacy [4]. Good medical records demonstrate that a service was provided to the patient and that the service was medically necessary. Regardless of the treatment outcome, thorough medical records protect the prescriber. DISCONTINUING OPIOID THERAPY The decision to continue or end opioid prescribing should be based on a joint discussion of the anticipated benefits and risks. An opioid should be discontinued with resolution of the pain condition, intolerable side effects, inadequate analgesia, lack of improvement in quality of life despite dose titration, dete- riorating function, or significant aberrant medication use [4]. Clinicians should provide physically dependent patients with a safely structured tapering protocol. Withdrawal is managed by the prescribing physician or referral to an addiction specialist. Patients should be reassured that opioid discontinuation is not the end of treatment; continuation of pain management will be undertaken with other modalities through direct care or referral.
CONCLUSION Opioid analgesic medications can bring substantial relief to patients suffering from chronic pain. However, the inappropri- ate use, abuse, and diversion of prescription drugs in America, particularly prescription opioids, has increased dramatically and has been identified as a national public health epidemic. Whenever opioids are necessary to manage chronic pain, healthcare professionals should take steps to ensure that these agents are used safely and appropriately.
WORKS CITED https://qr2.mobi/ Safe_Opioid_Trtment_Plan
Implicit Bias in Health Care The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, profes- sionals’ attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients’ trust and comfort with their provider, leading to earlier termina- tion of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health profes- sionals’ implicit biases can further exacerbate these existing disadvantages. Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control- based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual’s behaviors. These strategies include increas- ing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.
20
MDNJ1525
Powered by FlippingBook