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Related Concept Videos

Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Analgesia and Pain Management01:25

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Such synergistic combinations...
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High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry
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Multidisciplinary eConsults to Optimize Safe Opioid Prescribing: A Pilot Program.

Shakaib Khan1, Rebecca Andrews2, Kevin W Chamberlin3

  • 1Department of Psychiatry, Uconn Health, Farmington, Connecticut, USA.

Journal of Pain & Palliative Care Pharmacotherapy
|May 7, 2026
PubMed
Summary
This summary is machine-generated.

Primary care physicians can improve chronic pain management using a multidisciplinary electronic consult (eConsult) program. This approach significantly reduced opioid use and improved patient outcomes.

Keywords:
Chronic paineConsultmental healthmultidisciplinaryopioid

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Area of Science:

  • Pain Management
  • Primary Care Medicine
  • Psychiatry
  • Pharmacy

Background:

  • Chronic pain management presents significant challenges for primary care physicians (PCPs).
  • Many PCPs lack confidence in their pain management skills, impacting patient care.
  • A substantial number of patients are on long-term opioid therapy (LTOT), requiring careful management.

Purpose of the Study:

  • To evaluate the effectiveness of a multidisciplinary electronic consult (eConsult) program for guiding safe, evidence-based long-term opioid therapy (LTOT).
  • To assess the impact of integrated primary care, psychiatry, and pharmacy expertise on chronic pain management.
  • To determine changes in opioid dosage and adherence to recommendations in patients managed via eConsults.

Main Methods:

  • Development of a multidisciplinary eConsult program involving PCPs, a consult-liaison psychiatrist, and pharmacists.
  • Referral of patients on LTOT by care teams or via chart review.
  • Review of medical and psychiatric histories to recommend evidence-based management and further testing.
  • Chart reviews at 3, 6, and 12 months to assess changes in oral morphine equivalents (OME) and recommendation follow-through.

Main Results:

  • A statistically significant reduction in OME was observed at 12 months compared to baseline across all patient populations.
  • Following psychiatric recommendations was associated with improved outcomes.
  • The eConsult program facilitated access to specialized expertise for PCPs managing complex chronic pain.

Conclusions:

  • Multidisciplinary eConsults offer a valuable approach for managing patients on LTOT in primary care settings.
  • Integration of psychiatric and pharmacy expertise enhances the safety and efficacy of chronic pain management.
  • This model supports PCPs in providing evidence-based care for complex chronic pain patients.