{"id":220,"date":"2018-02-28T07:50:53","date_gmt":"2018-02-28T07:50:53","guid":{"rendered":"http:\/\/www.depts.washington.edu\/fammed\/improvingopioidcare\/?page_id=220"},"modified":"2021-05-03T20:01:41","modified_gmt":"2021-05-03T20:01:41","slug":"recommended-assessments","status":"publish","type":"page","link":"https:\/\/familymedicine.uw.edu\/improvingopioidcare\/helpful-resources\/recommended-assessments\/","title":{"rendered":"Recommended Assessments"},"content":{"rendered":"

The following table outlines recommended assessments, tools, and frequencies for caring for patients using opioid therapy.<\/p>\n

Suggested opioid management assessment schedule<\/a>
\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
What you are assessing<\/th>\nHow to assess<\/th>\nHow frequently to assess<\/th>\n<\/tr>\n
Specific diagnosis for pain<\/strong>
\nCheck that the patient has a diagnosis for their pain that will benefit from opioid medication.<\/td>\n		Based on history, physical examination, and testing (e.g., labs, imaging, as indicated)<\/td>\nFirst acute, subacute, and chronic pain visit and then at visits according to risk level<\/a><\/td>\n<\/tr>\n
Progress in meeting functional goals <\/strong><\/td>\nPain, Enjoyment, General activity scale (PEG<\/a>), documented patient-set goals<\/a> (e.g., walk to the park), reports by family (though not always reliable, can be useful), evidence of performing job or life role function<\/td>\nEvery visit when opioids are prescribed<\/td>\n<\/tr>\n
Potential benefits of non-opioid therapies<\/strong><\/td>\nDiagnosis, history, patient’s perspective, evidence (See integrative medicine table<\/a> and “Nonopioid Treatments for Chronic Pain”<\/a><\/td>\nFirst acute, subacute, and chronic pain opioid prescription visit and then at visits according to risk level<\/a><\/td>\n<\/tr>\n
Benefits and risks of continued opioid therapy<\/strong><\/td>\nBased on history, PEG<\/a>, MED<\/a>, COMM<\/a>, STOPBang<\/a>, PDMP<\/a>, UDT<\/a><\/td>\nA visit within 1 to 4 weeks of:\n
    \n
  • First chronic pain opioid prescription<\/li>\n
  • Increasing the dose of a chronic pain opioid prescription<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Potential for substance\/opioid misuse, abuse, or disorder<\/strong><\/td>\nPotential tools to use: ORT<\/a>, ORT-OUD<\/a>, SOAPP<\/a>, COMM<\/a>, DAST<\/a>, TAPS<\/a>, DSM-5<\/a>, OUD diagnosis form using DSM-5<\/a>
\nNote<\/em>: the ORT is validated for predicting risk of aberrant drug related behaviors while the ORT-OUD is validated for risk of developing opioid use disorder. See this article<\/a> for more information.<\/td>\n		First subacute or chronic pain visit<\/td>\n<\/tr>\n
Current substances used, including sedatives<\/a><\/strong> (e.g.,  benzodiazepines, carisoprodol)<\/strong><\/td>\nUDT<\/a> <\/u>\n

(Interpreting results<\/em><\/a>)<\/p><\/td>\n

First subacute or chronic pain visit and then visits according to risk level<\/a><\/td>\n<\/tr>\n
Current medications filled, including sedatives<\/a><\/strong> (e.g.,  benzodiazepines, carisoprodol)<\/strong><\/td>\nPDMP<\/a><\/td>\nFirst opioid prescription, at each transition to a new pain category (acute, subacute, chronic), and then at visits according to risk level<\/a><\/td>\n<\/tr>\n
Informed consent<\/strong><\/td>\nReview the patient agreement <\/a> and have the patient sign it <\/u><\/td>\nStart of long-term opioid therapy; annually<\/td>\n<\/tr>\n
Morphine equivalent dosing<\/strong><\/td>\nMED calculator<\/a><\/td>\nFirst opioid prescription and every change in opioid prescription<\/td>\n<\/tr>\n
Anxiety, depression<\/strong><\/td>\nPHQ<\/a>, GAD-7<\/a><\/td>\nAccording to risk level<\/a><\/td>\n<\/tr>\n
PTSD<\/strong><\/td>\nPC-PTSD<\/a><\/td>\nIf elevated PHQ or GAD despite active treatment<\/td>\n<\/tr>\n
Sleep apnea<\/strong><\/td>\nSTOPBang<\/a> (obstructive sleep apnea)\n

Epworth<\/a> (central sleep apnea)<\/p><\/td>\n

When co-occurring risks: MED ≥ 50, Concurrent use of benzodiazepines , COPD, restrictive lung disease, including kyphosis or thoracic scoliosis, BMI > 28, snoring, fatigue, witnessed irregular breathing<\/td>\n<\/tr>\n
Fibromyalgia<\/strong><\/td>\nPatient self-report tool<\/a><\/td>\nAs appropriate if pain is widespread and co-occurring symptoms such as fatigue, poor sleep, depression, abdominal and\/or urogenital pain during diagnosis<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"

The following table outlines recommended assessments, tools, and frequencies for caring for patients using opioid therapy. Suggested opioid management assessment schedule<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":10,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-section.php","meta":{"footnotes":""},"class_list":["post-220","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/familymedicine.uw.edu\/improvingopioidcare\/wp-json\/wp\/v2\/pages\/220","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/familymedicine.uw.edu\/improvingopioidcare\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/familymedicine.uw.edu\/improvingopioidcare\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/improvingopioidcare\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/improvingopioidcare\/wp-json\/wp\/v2\/comments?post=220"}],"version-history":[{"count":6,"href":"https:\/\/familymedicine.uw.edu\/improvingopioidcare\/wp-json\/wp\/v2\/pages\/220\/revisions"}],"predecessor-version":[{"id":1893,"href":"https:\/\/familymedicine.uw.edu\/improvingopioidcare\/wp-json\/wp\/v2\/pages\/220\/revisions\/1893"}],"up":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/improvingopioidcare\/wp-json\/wp\/v2\/pages\/10"}],"wp:attachment":[{"href":"https:\/\/familymedicine.uw.edu\/improvingopioidcare\/wp-json\/wp\/v2\/media?parent=220"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}