Managing Pain in Patients With Chronic Medical Illnesses and Serious Mental Illnesses

The American Journal of Hospice & Palliative Care
Sean O'MahonyAriel Card

Abstract

This study investigated the use of opioid treatment plans that included the implementation of opioid dependence risk with a validated screening tool and opioid dependence risk tool (UDT) in a noncancer palliative pain clinic. We retrospectively reviewed the medical records for diagnostic information, information on analgesic medications, daily morphine equivalent dose, presence of pain management agreements and opioid dependence risk tools (ORT), and UDT. We recorded hospital days and emergency department visits. Seventy-four patients were followed for a mean of 15.9 months. Ninety-three percent of patients had pain management agreements and 74% had ORT. The median score was 8: consistent with a high risk. More than half had UDT and 17.6% of patients had unexpected findings. Fifty-nine percent of patients had a psychiatric diagnosis. Hospital days and emergency department visits decreased by more than 30% ( P = .015 and P = .019). Significance of Findings: Both mental health problems and aberrant drug use were common in patients seen in a noncancer palliative care clinic. There were significant reductions in acute care utilization in the 12 months post intake in the clinic.

References

Dec 1, 1996·Psychiatric Services : a Journal of the American Psychiatric Association·B FelkerD Short
May 21, 2005·Journal of Pain and Symptom Management·Sean O'MahonyRichard Payne
Dec 13, 2005·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Lynn R Webster, Rebecca M Webster
Feb 5, 2008·Psychiatric Services : a Journal of the American Psychiatric Association·William B JaffeeRoger D Weiss
Feb 25, 2011·Journal of General Internal Medicine·Joanna L StarrelsBarbara J Turner

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Citations

May 19, 2021·Palliative Medicine·Jenny LauCamilla Zimmermann

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