- PtProtect® – Resources
- Tools to Implement Pain Management Testing in Your Practice
- Understand how to manage pain
- PainEDU REMS Education Program
- Free Opioid Dosing Guideline and DOH Pain Management Rules Online CME Activity
- Prescription Drug Monitoring Programs
- Patient Tools
- Assess the patient’s pain
- Patient Pain Assessments
- Talk with the patient – Patient Risk Assessments
- Keep a Current Chart – Document Patient’s Progress
- Washington State Pain Rules Information (2012)
- Final Rules: Washington Medical Quality Assurance Commission
- Washington State Pain Rules
- Interagency Guideline on Prescribing Opioids for Pain
- Dosing Calculator
- PtProtect® Pain Management Program
PtProtect® – Resources
Tools to Implement Pain Management Testing in Your Practice
The following resources are available to aid in the establishment of a patient pain medication monitoring process.
- How to Incorporate Pain Management Testing into Your Practice
- Pain Management Monitoring Program Increases Patient Compliance and Reduces ER Visits (case study). A detailed step-by-step case study outlines how one Oregon clinic successfully implemented pain medication management testing into their workflow.
- Contact PeaceHealth Laboratories to receive the Case Study Toolkit, including:
- Pain Medication Agreement Protocol
- Medication Agreement
- Narcotic Algorithm
- Chronic Pain Assessment Flow Process
- Pain Assessment Questionnaire
- UDT Collection Instructions
- Provider When/How to Order UDT Instructions
- Opioid Risk Tool (ORT) Patient Form
- Urine Drug Testing Frequency Guidelines – How often should you test your patients? National guidelines offer guidance for urine drug testing frequency based on patient risk.
- The Importance of Random Drug Testing – The following articles provide insight about why baseline and random urine drug testing of your pain patient population is important.
Courtesy of the American Pain Foundation, American Academy of Family Physicians, and Pain Medicine News.
How To Collect, Prepare, and Ship Specimens in the PtProtect Pain Management Program
The PainEDU REMS Education Program is a direct response to the FDA Risk Evaluation and Mitigation Strategy (REMS) and is sponsored and certified by Albert Einstain College of Medicine and Montefiore Medical Center. The course consists of three, one-hour CME activities totaling 3.0 AMA PRA Category 1 Credits, and focuses on the safe and effective managment of pain with ER/LA opioid analgesics in accordance with the FDA Blueprint. The CME content is directed towards prescribers of ER/LA opioid analgesics, but is also relevant for other health care professionals.
The Medical Quality Assurance Commission, in consultation with the Department of Health and the Agency Medical Directors’ Group, presents a FREE CME activity that offers four (4) hours of: Category 1 Credits™ or Washington Board of Pharmacy approved Continuing Education (C.E.) Credit(s).
Prescription Drug Monitoring Programs
- National Institute on Drug Abuse
- DEA Diversion – State RX Monitoring Programs
- National Association of State Controlled Substance Abuse Authorities
- Oregon Prescription Drug Monitoring Program
- Oregon Prescription Drug Monitoring Program – Reports
- Washington Prescription Drug Monitoring Program
- Pain managemement tools can help patients to understand their pain and to work more effectivelty with their providers toward a higher quality of life.
- This pain log is a valuable online resource to track patterns and triggers in pain experiences over a period of time. It focuses on the impact pain has in multiple dimensions of a patient’s life – from mood to appetite to worries.
- A wallet medication card provides a place where patients list their medications to share wtih any health care provider who might prescribe medications. This tool promotes communication to avoid dangerous medication combinations.
- This constipation conversation guide can assist patients in communicating with providers about opioid-induced constipation.
Patient Pain Assessments
This pain assessment tool facilitates the communication of pain severity especially in older patients and those with diminished cognitive capacity and difficulty with abstract thinking. Courtesy of painknowledge.org.
A visual analog scale to assess pain in pediatric patients.
WHO has developed a three-step “ladder” for cancer pain relief.
Talk with the patient – Patient Risk Assessments
- CAGE Questionnaire
Used in Identifying Alcoholism
- Current Opioid Misuse Measure (COMM)
Helps clinicians identify whether a patient, currently on long-term opioid therapy, may be exhibiting aberrant behaviors associated with misuse of opioid medications. (free registration required)
- ORT Overview | Opioid Risk Tool
A brief, easy-to-use screening tool administered during the initial clinical visit which enables the clinician to determine a patient’s potential risk to develop aberrant behaviors when prescribed opioids chronic pain. Courtesy of painknowledge.org.
- Screener and Opioid Assessment for Patients with Pain (SOAPP)
This easy tool facilitates a patient assessment and plan for chronic pain patients being considered for long-term opioid treatment (free registration required).
- Patient Health Questionnaire (PHQ-9)
A brief questionnaire to assess a patient for depression. Courtesy of Pfizer.
- Opioid Facts
Printable patient-education handout. Courtesy of painknowledge.org.
- Pain Facts
Printable, patient-education handout. Courtesy of painknowledge.org.
- Informed Consent
This form verifies the patient understands the risks and benefits of using opioids. Your state may require an Informed Consent form to be signed by the patient for whom opioid medications are being considered. Please check with your state regulatory agency. Courtesy of painknowledge.org.
- Opioid Agreement Template
Patient agreements for chronic opioid treatment establish trust and accountability; health care providers may wish to include a copy in their patient’s records. This patient agreement template can be customized to your practice.
- Medication Flow Chart
Keeps track of a patient’s prescribed medications. Courtesy of painknowledge.org.
- Patient Reassessment Opioid Analgesic 4-A’s+ Chart Note
The 4-A’s+ Chart Note is a brief, easy-to-use tool to document a patient’s ongoing opioid treatment plan. Courtesy of painknowledge.org.
- Exit Strategy Guide
If the pain management plan for a patient must be discontinued, an exit strategy should be established. Courtesy of painknowledge.org.
Final Rules: Washington Medical Quality Assurance Commission
Rules related to chronic non-cancer pain management were adopted in Washington State January 2, 2012. These rules relate to dosing criteria and guidance on: seeking consultations, tracking progress and tracking the use of opioids. Full text documents of the Washington State rules for medical doctors, physician’s assistants and other specialties can be found at: Washington State Department of Health: Adopted Rules
Washington State Pain Rules
A breif overview of the Washington state pain rules can be found in the Physician Alert, released December 15, 2011 by PeaceHealth Laboratories:
Washington Activates New Rules for Pain Management January 2, 2012
Interagency Guideline on Prescribing Opioids for Pain
The Agency Medical Directors’ Group has published comprehensive guidelines for a balanced approach to pain management. The 2015 update was developed in partnership with academic leaders, pain experts, and clinicians in both primary care and specialty areas:
2015 AMDG Interagency Guideline Prescribing Opioids for Pain
The Agency Medical Directors’ Group offers this tool to assist providers in assessing their patient’s dosage in morphine equivalents per day:
Web-Based Opioid Dose Calculator
PtProtect® Pain Management Program
For clinicians working with patients suffering from chronic, non-cancer