Management of chronic noncancer pain in the primary care setting Journal Article

Authors: Nicholson, B.; Passik, S. D.
Article Title: Management of chronic noncancer pain in the primary care setting
Abstract: While opioids are regarded as the mainstay of chronic pain management, their use is controversial in the minds of many primary care physicians due to clinical concerns about dependence, abuse, and addiction and medicolegal concerns regarding state and federal regulatory authorities. For patients with moderate to moderately severe pain, the treatment of choice is a long-acting opioid or opioid combination drug product to provide sustained analgesia along with improvements in sleep quality, compliance, and possibly quality of life. Careful screening of patients being considered for long-term opioid therapy with validated questionnaires can identify patients who may have difficulties in managing opioids. These patients should not be denied access to opioid therapy, but they do require focused monitoring and case management. Ongoing monitoring should focus on the 4 A's (ie, analgesia, activities of daily living, adverse effects, and aberrant drug-related behaviors), and all aspects of patient care must be thoroughly documented.
Keywords: safety; osteoarthritis; pain management; double-blind; efficacy; controlled phase-iii; addiction; chronic noncancer pain; opioid therapy; moderate; nonmalignant pain; controlled-release opioids; oxymorphone extended-release
Journal Title: Southern Medical Journal
Volume: 100
Issue: 10
ISSN: 0038-4348
Publisher: Lippincott Williams & Wilkins  
Date Published: 2007-10-01
Start Page: 1028
End Page: 1036
Language: English
ACCESSION: WOS:000250271700017
PUBMED: 17943050
Notes: --- - Review - "Source: Wos"
Citation Impact
MSK Authors
  1. Steven D Passik
    122 Passik