Chronic pain

From mdEBMwiki
Jump to: navigation, search

Chronic Pain Management & Conversion

Check Prescription Drug Monitoring System

Review with patient that you will be checking Prescription drug monitoring program

Calculate risk Opioid risk tool

Discuss risk with patient
Consider Non-opioid pain medications
CDC Opioid Prescribing Guideline
Discuss functional goals and state them in the chart (ie. work 4 days a week)
Review expectations of 1 prescriber for pain medicine
Discuss the need for urine drug testing and compliance with expectations from a discordant screen
Discuss the need for random pill counts


1. Total Daily Dose (include sum of long acting and short acting agents): ***

2. Oral Morphine Equivalent (OME) (use conversion chart): ***

3. Calculate adjusted OME for incomplete cross-tolerance (aOME = OME x 0.66): ***

4. Convert aOME to new Total Daily Dose (TDDnew) by using conversion chart: ***

5. Divide by dosing interval (TDDnew/dosing interval): ***

6. Calculate breakthrough dosing (TDDnew x 0.15) to give Q4H PRN: ***

Long acting regimen: ***

Short acting regimen: ***

Adjunct pain therapy (i.e. TCA, muscle relaxant, etc.): ***

Verified pain contract on file: ***

Consideration of pill count: ***

Consideration of urine drug screen: ***

Useful Link

Global RPH Narc Converter

Opioid risk tool

Personal tools