• Subst Abuse Treat Prev Policy · Jun 2018

    Review

    Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice.

    • Johan Kakko, Charlotte Gedeon, Mikael Sandell, Henrik Grelz, Inge Birkemose, Thomas Clausen, Valgerður Rúnarsdóttir, Kaarlo Simojoki, Richard Littlewood, Hannu Alho, and Fred Nyberg.
    • Department of Clinical Sciences, Psychiatry, Umeå University, Psykiatriska Kliniken Umeå, Norrlands Universitetssjukhus, SE-901 85, Umeå, Sweden. johan.kakko@vll.se.
    • Subst Abuse Treat Prev Policy. 2018 Jun 1; 13 (1): 22.

    BackgroundLong-term use of opioid analgesics (OA) for chronic pain may result in opioid use disorder (OUD). This is associated with adverse outcomes for individuals, families and society. Treatment needs of people with OUD related to chronic pain are different compared to dependence related to use, and also injection, of illicit opioids. In Nordic countries, day-to-day practical advice to assist clinical decision-making is insufficient.AimTo develop principles based on expert clinical insights for treatment of OUD related to the long-term use of OA in the context of chronic pain.MethodsCurrent status including an assessment of barriers to effective treatment in Finland, Denmark, Iceland, Norway, Sweden was defined using a patient pathway model. Evidence to describe best practice was identified from published literature, clinical guidelines and expert recommendations from practice experience.ResultsAvailability of national treatment guidelines for OUD related to chronic pain is limited across the Nordics. Important barriers to effective care identified: patients unlikely to present for help, healthcare system set up limits success, diagnosis tools not used, referral pathways unclear and treatment choices not elucidated. Principles include the development of a specific treatment pathway, awareness/ education programs for teams in primary care, guidance on use of diagnostic tools and a flexible treatment plan to encourage best practice in referral, treatment assessment, choice and ongoing management via an integrated care pathway. Healthcare systems and registries in Nordic countries offer an opportunity to further research and identify population risks and solutions.ConclusionsThere is an opportunity to improve outcomes for patients with OUD related to chronic pain by developing and introducing care pathways tailored to specific needs of the population.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…