There is a significant body of evidence suggesting that many Americans suffer from chronic pain and much of that pain is inadequately or ineffectively treated. Particularly in the case of chronic pain treatment via opioid analgesics, proper chronic pain management is critical in determining whether opioids are used in a manner that is both medically appropriate and in compliance with regulations. Pain management is an important area of patient care that is integral to the practice of medicine, yet so often it is mismanaged. Here we review six most common ways pain is mismanaged:
- Inadequate attention to patient education and informed consent. Deciding to begin opioid therapy for chronic pain should only be made after a physician and patient discuss the risks. Pain patients should have a clear understanding that the clinical basis for the use of these medications for chronic pain is limited, risk of addiction is real, and that taking opioids with other substances or certain conditions (i.e. depression or a history of substance abuse) may further increase risk.
- Inadequate attention to initial assessment. A proper assessment will help to determine if an opioid based pain treatment regime is medically appropriate and necessary. It will also help in uncovering risks associated with use for a particular individual.
- Inadequate monitoring during the use of habit forming medications. Due to its highly addictive and dangerous nature, opioids are associated with drug addiction and abuse. Chronic pain treatment benefit from opioid dose reductions or tapering or weaning off the opioid.
- Excessive reliance on opioids for chronic pain management without adequate attention to alternative treatments. Prescribers should use opioid therapy only when safer and equally as effective alternative therapies prove to be ineffective.
- Baseless dosage increases without adequate attention to risks or alternative treatments. The risks associated with opioids increase with higher doses and even more in conjunction with other comorbidities (i.e. mental illnesses, respiratory disorders, pre-existing substance use disorder and sleep apnea) and with concurrent use with respiratory depressants such as benzodiazepines or alcohol.
- Lack of utilization of available tools or lack of knowledge of available tools for risk mitigation. Our Pharmacotherpay Review program uncovers major issues including duplicate therapies, dangerous or deadly drug interactions, or behaviors related to drug addiction. All of which can have a dramatic impact on a patient’s health.
ANS Pharmacotherapy Review
A well informed physician’s practice can improve safety and the outcome of chronic pain treatment for patients. This is an area where the expert medical cost containment solutions of ANS Solutions can help. Our Pharmacotherapy Review Program provides three highly effective stages that not only contribute to lower medical costs in workers’ compensation claims, but greatly enhance the quality of life and care for injured workers.
For more information, visit www.ans-solutions.com.
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