Monitoring outcomes during long-term opioid therapy for noncancer pain: results with the Pain Assessment and Documentation Tool.

Full Abstract

The increasingly common practice of long-term opioid therapy for chronic noncancer pain must be guided by ongoing assessment of four types of outcomes:
pain relief, function, side effects, and drug-related behaviors. Our objective was to gather initial pilot data on the clinical application of a specialized chart note, the Pain Assessment and Documentation Tool (PADT), which was developed and tested with 27 physicians. This pilot test provided the means to collect cross-sectional outcome data on a large sample of opioid-treated chronic pain patients. Each of the physician volunteers (located in a variety of settings across the United States) completed the PADT for a convenience sample of personally treated chronic pain patients who had received at least three months of opioid therapy. Completion of the PADT required a clinical interview, review of the medical chart, and direct clinical observation. Data from the PADTs were collated and analyzed. The results suggested that the majority of patients with chronic pain achieve relatively positive outcomes in the eyes of their prescribing physicians in all four relevant domains with opioid therapy. Analgesia was modest but meaningful, functionality was generally stabilized or improved, and side effects were tolerable. Potentially aberrant behaviors were common but viewed as an indicator of a problem (i.e., addiction or diversion) in only approximately 10 percent of cases. Using the PADT physician ratings can be developed in four domains. In this sample, outcomes suggested that opioid therapy provided meaningful analgesia.

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Author information

Author/s: Passik, Steven D (SD); Kirsh, Kenneth L (KL); Whitcomb, Laurie (L); Schein, Jeffrey R (JR); Kaplan, Mitchell A (MA); Dodd, Sheri L (SL); Kleinman, Leah (L); Katz, Nathaniel P (NP); Portenoy, Russell K (RK);

Affiliation: Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Journal and publication information

Publication Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't

Journal: Journal of opioid management (J Opioid Manag), published in United States. (Language: eng)

Reference: -2005 Nov-Dec; vol 1 (issue 5) : pp 257-66

Dates: Created 2007/02/26; Completed 2007/03/14; Revised 2007/11/15;

PMID: 17319559, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Activities of Daily Living
Adult
Aged
Aged, 80 and over
Analgesics, Opioid - adverse effects; therapeutic use
Female
Humans

Interviews as Topic
Male
Middle Aged
Pain - drug therapy
Pain Measurement - methods
Pilot Projects
Treatment Outcome

Associated Chemicals: Analgesics, Opioid (0)

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