The Acute Pain Assessment and Opioid Prescribing Protocol is currently under revision.

The Acute Pain Assessment and Opioid Prescribing Protocol was developed in response to community and national concern over the misuse, abuse and diversion of opioids. It focuses on the acute pain phase and, potentially, the first prescription of opioids. It encourages the exploration of all options for pain management, followed by careful opioid risk assessment and shared decision-making with the patient, prior to prescribing. The document is structured similarly to a guideline but because of limited evidence, meets only protocol standards. It includes risk assessment tools and guidance for talking with patients about opioids.

Protocol Summary

Revision Date: January 2014
First Edition

Scope and Target Population

This protocol will include recommendations for acute pain assessment, risk assessments, therapies and treatment options, and conservative opioid prescribing for:

• the adult, non-cancer, acute and subacute pain outpatient;
• the adult, non-cancer chronic pain patient experiencing unrelated acute pain; and
• the adult, non-cancer patient with acute exacerbation of chronic pain.

The target population is the adult (18 years and older) non-cancer, acute or subacute pain outpatient.
The assessment of pain and management of patients with active cancer and/or receiving palliative or hospice care, including non-cancer diagnoses, are not addressed within the context of this protocol and are out of the scope and target population.

Aims

1. Decrease the rate of opioid prescriptions for adults 18 years and older with diagnoses that do not warrant opioids (diagnoses may include fibromyalgia, headache, sore throat, uncomplicated neck and back pain, uncomplicated musculoskeletal pain).
2. Increase the number of opioids prescriptions for adults 18 years and older that have documented review of prescription monitoring program in EHR.
3. Decrease the rate of adult patients 18 years and older with opioid prescriptions for non-traumatic tooth pain.
4. Increase the rate of adult patients 18 years and older who receive information on risks and benefits of opioid prescription.