Review of Opioid Risk Assessment Tools with the Growing Need for Telemedicine

Abstract

Fortunately, all opioid screening tools can be completed remotely, either by the patient independently or with a provider via telemedicine. This process can be streamlined by integrating the screening tool into an electronic patient portal, where patients have access to their medical information, so that both the tool can be completed and the results are readily available for review and to be tracked. "Practice points• Many routine practices of chronic pain management have had to be adjusted in the COVID-19 era.• There are multiple validated risk assessment tools established to screen for patients at high risk for opioid misuse as well as maintain opioid therapy. • The pain medication questionnaire and brief risk questionnaire are the best supported tools for initiating opioid therapy in the in-person outpatient setting, therefore either of them would make a good choice as part of a telehealth visit for starting patients on opioids. • The Current Opioid Misuse Measure and the Screener and Opioid Assessment for Patients with Pain-Revised have performed well in the outpatient setting for maintaining patients on opioid therapy; together they would provide the best information at a telehealth visit. • The Current Opioid Misuse Measure may help indicate who has developed aberrant behavior, while the Screener and Opioid Assessment for Patients with Pain-Revised can predict future misuse. • As most studies performed on risk assessment tools were not tested in telemedicine settings, there is a need for direct studies to better evaluate their use in telemedicine.

Management of Co-Occurring SUD and Chronic Pain

“…As the COVID-19 pandemic ushered in a sudden and widespread adoption of telemedicine by necessity, the care of patients being prescribed controlled substances was immediately transformed. The use of these screening tools may assist providers with determination of which patients are appropriate for continued support with telemedicine, and which require assessment in clinic with appropriate thorough risk assessment including physical exam, urine toxicology screening, pill count, or other measures not accessible via telehealth [36].…”