A new tool to assess and document pain outcomes in chronic pain patients receiving opioid therapy

Risk Factors in Opioid Treatment of Chronic Non-Cancer Pain: A Multidisciplinary Assessment

“…The Pain Assessment and Documentation Tool (PADT; Passik et al, 2004;Passik et al, 2005) is a brief (takes between 10 to 20 minutes to complete) clinician-directed interview. The clinician asks the patients questions that are organized in four primary areas called the "Four A's" and are notably: Analgesia -focuses on pain intensity (numeric rating scales) and pain relief; Activities of Daily Living -focuses on whether the patient's functioning since the last assessment is better, same, or worse; Adverse Events -identifies whether the patient is experiencing side effects from current pain relievers, and if so, what they are; potentially Aberrant Drug-Related Behaviours -assesses 17 aberrant behaviours.…”

Improving Chronic Pain Management Processes in Primary Care Using Practice Facilitation and Quality Improvement: The Central Appalachia Inter-Professional Pain Education Collaborative

“…A comprehensive list of chronic pain process measures was assessed for each clinic regardless of the best practice process that was actually implemented by the clinic. The outcomes, aligned with the National Pain Strategy overarching plan, included presence of a clinic opioid policy, clinic workflow, a physical exam, UDS ordered within last 12 months, a controlled medication agreement, use of nonopioid medications and integrative therapies, use of diagnostic testing, referral to specialists, use of pain-specific notes (ie, the Pain Assessment and Documentation Tool 29 ), and whether goals were discussed with the patient. In addition, documentation of measured pain and use of mood disorder (GAD-7 30 and PHQ-9 31 ), risk (Opioid Risk Tool 32 ) and functional assessment (Pain Disability Index 33 ) tools were reviewed.…”

Opioid therapy for chronic non-cancer pain: guidelines for Hong Kong

“…During an opioid trial, the patient is regularly monitored, usually at weekly intervals, to assess the four A's: analgesia, activity, adverse effects, and aberrant behaviour. 33,60,67 The dose is adjusted based on changes in pain intensity, improvements in daily function, and development of side-effects and of aberrant behaviour. 33,35,46 Validated pain assessment tools such as the Brief Pain Inventory or the Pain, Enjoyment, and General Activity scale may be used at baseline and at regular intervals thereafter to describe changes in pain relief and function.…”