VA/DoD CLINICAL PRACTICE GUIDELINE FOR OPIOID THERAPY FOR CHRONIC PAIN
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<strong>VA</strong>/<strong>DoD</strong> Clinical Practice Guideline for Opioid Therapy for Chronic Pain<br />
Question<br />
Interventions<br />
Naloxone rescue with one form of naloxone<br />
Informed consent<br />
Use of written informed consent (previously called contracts)<br />
Risk assessment instruments<br />
Opioid management plans<br />
Patient education<br />
Urine drug testing (UDT)<br />
Prescription drug monitoring program (PDMP)<br />
Monitoring instruments<br />
More frequent monitoring<br />
7<br />
Pill counts<br />
Use of abuse–deterrent formulations<br />
Diversion prevention interventions (e.g., properly securing drugs, medication take back programs, public<br />
health education)<br />
Pharmacogenetic testing<br />
Random call-backs<br />
Compliance with other therapies<br />
Case management<br />
Periodic check of state databases<br />
Needle exchange programs<br />
Treatment with at least one of the following:<br />
• Buprenorphine (with or without naloxone)<br />
• Methadone<br />
• Injectable/oral naltrexone<br />
• Medical Management<br />
8<br />
• Contingency Management<br />
• Individual Drug Counseling<br />
• Motivational interviewing<br />
• Motivational Enhancement Therapy<br />
• Other motivational approaches<br />
9 One tapering strategy or schedule<br />
c. Comparator(s)<br />
Table E-3 lists the comparators of interest to this systematic review. The comparators are listed by the KQ<br />
they address.<br />
February 2017 Page 109 of 192
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