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Published on: April 14, 2016
Reviewing long-term opioid use in patients experiencing chronic pain in general practice: Activating patients and
Hester Hk Wilson1, Louisa Picco2, Suzanne Nielsen3
1BMed (Hons) FRACGP, FAChAM, MMH, General Practitioner, Alice St General Practice, Newtown, NSW; Staff Specialist in Addiction, Drug and Alcohol Services, South Eastern Sydney Local Health District, Caringbah, NSW; Conjoint Lecturer, School of Population Health, University of NSW, Kensington, NSW; Centre for Primary Health Care and Equity (CPHCE), University of New South Wales, Kensington, NSW.
Background:
Australia has a high rate of opioid prescribing, which has been associated with multiple harms. Regular review of patients' opioid-related risk factors and realigning treatment improves clinical outcomes; however, general practitioners (GPs) can find this consultation difficult.
Objective:
The aim of this article is to support GPs and their chronic pain patients who have been prescribed long-term opioids with a structured and validated opioid review process through the Routine Opioid Outcome Monitoring (ROOM) tool and the patient-led Opioid Safety Toolkit.
Discussion:
The ROOM tool is a validated patient-reported measure that assists with assessment of current pain, functioning, risk of dependence, mood, constipation and risky alcohol use. The online Opioid Safety Toolkit improves patient health literacy and activation in their pain management. These tools, combined with real-time prescription monitoring (RTPM) information and naloxone for opioid overdose, can provide a comprehensive, efficient approach that helps identify and manage medication-related risks, supports quality use of opioids and assists conversations with patients regarding best treatment options.
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Assessment:
Nociception

