Managing Chronic Pain

The goal of this handbook is to assist clinicians in managing adult patients with chronic non-malignant pain. This information is based on current consensus guidelines, expert opinion and studies when available. Despite an obvious need, the medical literature does not yet contain the high quality randomized controlled trials required to establish evidenced-based clinical standards for the management of chronic non-malignant pain.

Our discussion focuses on the use of long-term opioids because this is reported to be the area that is most challenging for clinicians. We acknowledge that opioids represent only one component of pain management and expect treatment plans to be highly individualized based on the medical, psychological and social needs of a particular patient.

David Labby, MD
Michele Koder, PharmD
Ted Amann, RN

 

 

Acknowledgements
We would like to thank all of those who reviewed drafts and provided detailed comments to help create this handbook: David Balmer, MD; Paul Bascom, MD; Joe Black, MD; Elizabeth Clark, MD; Lisa Dodson, MD; Marilee Donovan, PhD, RN; Mari-Lynn Drainoni, PhD; Bruce Goldberg, MD; Richard Gicking, MD; Dean Haxby, Pharm D; Meg Hayes, MD; Patsy Kulberg, MD; Sue Millar, Pharm D; Lori Linton Nelson, RN, MN, PMHNP; Karen Amann Talerico, PhD, RN, CNS. Their many suggestions were critical in developing our approach and presentation, however the opinions expressed in the final product are the responsibility only of the authors.

Disclaimer
The information contained herein is provided in good faith to assist clinicians in managing patients with chronic pain. Recommendations are based on consensus guidelines, published medical literature, and expert opinion, and are not to be considered evidence-based or comprehensive in nature. Additionally, these recommendations are dynamic and will be revised as new information becomes available. This information is advisory only and is not intended to replace FDA-approved labeling information, or sound clinical knowledge, judgment, and expertise in the provision of healthcare. CareOregon assumes no responsibility for the actions of clinicians based upon their reliance on the information contained herein. Selection and management of drug therapy for individual patients is ultimately based on clinicians’ assessment of clinical circumstances and patient needs.