Management of chronic noncancer pain in the primary care setting.

Abstract:

:While opioids are regarded as the mainstay of chronic pain management, their use is controversial in the minds of many primary care physicians due to clinical concerns about dependence, abuse, and addiction and medicolegal concerns regarding state and federal regulatory authorities. For patients with moderate to moderately severe pain, the treatment of choice is a long-acting opioid or opioid combination drug product to provide sustained analgesia along with improvements in sleep quality, compliance, and possibly quality of life. Careful screening of patients being considered for long-term opioid therapy with validated questionnaires can identify patients who may have difficulties in managing opioids. These patients should not be denied access to opioid therapy, but they do require focused monitoring and case management. Ongoing monitoring should focus on the 4 A's (ie, analgesia, activities of daily living, adverse effects, and aberrant drug-related behaviors), and all aspects of patient care must be thoroughly documented.

journal_name

South Med J

journal_title

Southern medical journal

authors

Nicholson B,Passik SD

doi

10.1097/SMJ.0b013e3180f626ff

subject

Has Abstract

pub_date

2007-10-01 00:00:00

pages

1028-36

issue

10

eissn

0038-4348

issn

1541-8243

pii

00007611-200710000-00021

journal_volume

100

pub_type

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