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

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DRAFT 3 - DO NOT DISTRIBUTE VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain Concept Controlled Vocabulary Keywords drug therapy/sh *hypnotic drugs/ Insomnia.id. Major depression.id. Exp polypharmacy/ Schizophrenia.id. Exp sedatives/ Exp self medication/ KQ 7 Risk mitigation strategies What is the comparative effectiveness of different risk mitigation strategies for patients either on LTOT or being considered for LTOT? Does this differ for patients with history of or current SUD? Does this differ for patients with mental health comorbidities? Does this differ for patients with medical comorbidities? KQ 8 Treatment of OUD What is the safety and effectiveness of EMBASE ‘naloxone’/exp ‘opiate addiction’/exp ‘patient education’/exp ‘prescription drug diversion’/exp ‘risk reduction’/exp ‘substance abuse’/exp ‘urinalysis’/exp MeSH ‘contracts’ ‘drug monitoring’ exp ‘patient compliance’/ exp ‘risk’/ PsycINFO exp addiction/ Exp client education/ exp drug abuse/ drug abuse.sh. exp drug addiction/ opiates.id. exp monitoring/ exp naloxone/ exp patient compliance/ Exp prescription drugs/ Exp risk assessment/ Exp risk evaluation and mitigation strategy/ Exp risk perception/ Exp treatment compliance/ Exp urinalysis/ EMBASE 'acceptance and commitment therapy'/exp ‘addiction’/exp Abuse Addict* agreement ‘call back’ Call-back Compliance comply consent contract database diversion divert doctor Detect* Diversion Divert Misuse Mitigat* Monitor* naloxone Naloxone NEXT/2 rescue office Pill NEXT/2 count physician primary Precaution* Query Recall Rescue Risk* Risk NEXT/5 reduc* Risk NEXT/5 mitigat* Screen* surveillance Test* Urin* aberrant Abuse Addict* Behavioral February 2017 Page 166 of 192
DRAFT 3 - DO NOT DISTRIBUTE VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain Concept Controlled Vocabulary Keywords treatment of OUD ‘analgesic agent abuse’/exp buprenorphine (diagnosed or suspected) ‘cognitive therapy’/exp Cognitive in patients with chronic ‘drug abuse’/exp Contingency pain? ‘drug dependence’/exp ‘contingency management’ Do outcomes vary by ‘narcotic analgesic agent’/exp Counsel* severity of OUD? ‘narcotic dependence’/exp counseling ‘opiates’/exp drug ‘opiate addiction’/exp interview* ‘psychotherapy’/exp methadone ‘support group’/exp misuse MeSH motivation* ‘analgesics, opioid’/exp naltrexone ‘cognitive therapy’/exp therapy ‘counseling’/exp treat* ‘motivational interviewing’/ treatment ‘narcotics’/exp ‘substance abuse detection’/exp ‘substance-related disorders’/exp PsycINFO exp addiction/ Exp adjunctive treatment/ Exp cognitive therapy/ Exp counseling/ exp drug abuse/ drug abuse.sh. exp drug addiction/ exp drug dependence/ electrosleep treatment/ exp motivational interviewing/ exp opiates/ opiates.id. Exp prescription drugs/ Exp psychotherapy/ Exp support group/ Exp treatment/ Exp treatment compliance/ Exp treatment effectiveness evaluation/ Exp treatment outcomes/ KQ 9 Tapering What is the safety and effectiveness of different tapering strategies and schedules? EMBASE ‘analgesia’/exp ‘clinical protocol’/exp ‘dose response’/exp ‘drug administration’.exp ‘drug therapy’/lnk ‘pain management’/exp MeSH ‘clinical protocols’/exp ‘drug administration schedule’/exp PsycINFO Adjust* administration Decrease* Dose Dosing plan protocol Reduc* Schedule Strategy February 2017 Page 167 of 192
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VA/DoD CLINICAL PRACTICE GUIDELINE
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VA/DoD Clinical Practice Guideline
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Appendix D: Drug Tables A. Short-ac
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Short-Acting Opioid Initial Oral Do
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Short-Acting Opioid Initial Oral Do
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Short-Acting Opioid Tramadol (alone
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Long-Acting/ER Opioids 1 Buprenorph
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Long-Acting/ER Opioids 1 Hydrocodon
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Long-Acting/ER Opioids 1 Initial Do
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3 CYP-3A4 inhibiting agents include
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VA/DoD CLINICAL PRACTICE GUIDELINE FOR OPIOID THERAPY FOR CHRONIC PAIN

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