VA/DoD CLINICAL PRACTICE GUIDELINE FOR OPIOID THERAPY FOR CHRONIC PAIN

Recommendations

Info

DRAFT 3 - DO NOT DISTRIBUTE VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain Concept Controlled Vocabulary Keywords or OUD when considering LTOT? ‘risk’/exp ‘sexual abuse’/exp Bullying Day* a. What are the risks for MeSH dependency long-term use associated ‘bullying’/ Disorder* with acute use of opioids ‘domestic violence’/exp Early in treating acute pain? ‘risk assessment’/exp Initial ‘substance-related disorders’/exp PsycINFO Exp addiction/ Exp at risk populations/ Exp codependency/ Exp drug abuse/ Exp drug addiction/ New New onset Overdose* Predict* Risk* Short term violence Exp drug overdoses/ Exp illegal drug distribution/ Exp risk assessment/ Exp risk factors Exp risk perception/ KQ 3 AND KQ 4 Effectiveness of LTOT What is the comparative effectiveness of LTOT versus other treatment modalities? What is the comparative effectiveness of LTOT versus other treatment modalities for patients with a history of or current SUD? Safety of LTOT What is the safety of LTOT versus other treatment modalities? a. What is the safety of LTOT versus other treatment modalities for patients with a history of or current SUD? EMBASE ‘adverse drug events’/exp ‘adverse drug reaction’/exp ‘adverse drug reaction’/lnk ‘drug overdose’/exp ‘patient safety’/exp ‘prescription drugs’/exp ‘side effect’/lnk ‘side effect’/de ‘treatment outcome’/de MeSH ‘analgesics, opioid’/*adverse effects ‘prescription drugs’/adverse effects ‘quality of life’ ‘risk’ ‘side effect’/de ‘treatment outcome’ PsycINFO *quality of life/ “side effects (drug)”/ *treatment outcomes/ Drug overdose/*prevention & control Aberrant NEXT/3 behavior* Absence absent Abuse Accident* ‘ade’ Addict* adverse ‘adverse drug events’ Adverse NEXT/1 effect* Anxiety cardiac cardiovascular cognitive complication depression Disorder* Diversion effective effectiveness Fall Falls Harm* Misuse Mood Outcome* Overdose* ‘pain relief’ Pain NEXT/2 relief Pain NEXT/3 reliev* February 2017 Page 164 of 192
DRAFT 3 - DO NOT DISTRIBUTE VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain Concept Controlled Vocabulary Keywords poison* ‘quality of life’ QOL Safety ‘side effect*’ Sleep s KQ 5 Effectiveness of different opioid formulations What is the comparative effectiveness and safety of various opioid formulations? Immediate-release/shortacting opioids compared to ER/long-acting opioids Route of administration/ delivery alternatives such as transdermal, buccal, sublingual, pumps Abuse deterrent formulations compared to non-abuse deterrent formulations Tramadol and other dualmechanism opioids Buprenorphine Methadone KQ 6 Added benzodiazepines Does additional use of benzodiazepines or other psychoactive medications increase the risk of adverse events compared to OT alone? EMBASE ‘short acting analgesic agent’/exp MeSH ‘analgesics, short-acting’ PsycINFO *drug therapy EMBASE ‘antidepressant agent’/exp ‘benzodiazepine’ ‘benzodiazepine derivative’/exp ‘hypnotic sedative agent’/exp ‘narcotic analgesic agent’/exp ‘non prescription drug’ ‘prescription drug’ MeSH ‘patient safety’ ‘polypharmacy’/exp ‘safety’ PsycINFO exp analgesic drugs/ Exp anesthetic drugs/ Exp anticonvulsive drugs/ Exp antidepressant drugs/ Exp antiemetic drugs/ Exp antihistaminic drugs/ Exp antihypertensive drugs/ exp benzodiazepines/ exp cns depressant drugs/ Abuse-deterrent controlled ‘controlled release’ extended ‘extended release’ Formulation immediate ‘immediate release’ LA ‘long?acting’ Medication Medicine Pill* Prescription* SA ‘short?acting’ (short* OR long* OR immediate OR extended OR controlled OR sustained AND (release* OR act*)) Sustained Ambien ‘anti depressant’ Antidepressant* Anti-depressant’ Benzodiazepine* 'eszopiclone' Hypnotic* lunesta OTC ‘over-the-counter’ ‘over the counter’ prescription* polypharmacy psychoactive* sonata stimulant* ‘z drug’ ‘z drugs’ 'zaleplon' 'zolpidem' February 2017 Page 165 of 192
Page 1 and 2:
VA/DoD CLINICAL PRACTICE GUIDELINE
Page 3 and 4:
VA/DoD Clinical Practice Guideline
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
Appendix D: Drug Tables A. Short-ac
Page 83 and 84:
Short-Acting Opioid Initial Oral Do
Page 85 and 86:
Short-Acting Opioid Initial Oral Do
Page 87 and 88:
Short-Acting Opioid Tramadol (alone
Page 89 and 90:
Long-Acting/ER Opioids 1 Buprenorph
Page 91 and 92:
Long-Acting/ER Opioids 1 Hydrocodon
Page 93 and 94:
Long-Acting/ER Opioids 1 Initial Do
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
3 CYP-3A4 inhibiting agents include
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114: VA/DoD Clinical Practice Guideline
Page 163: DRAFT 3 - DO NOT DISTRIBUTE VA/DoD
Page 167 and 168: DRAFT 3 - DO NOT DISTRIBUTE VA/DoD
show all

VA/DoD CLINICAL PRACTICE GUIDELINE FOR OPIOID THERAPY FOR CHRONIC PAIN

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?