Monitoring Treatment Response
Those receiving chronic opioid therapy should be monitored for response to treatment. Evidence of what will constitute a positive response to opioid medication therapy should be defined before treatment is started and should include an increase in function (e.g. improvement in ability to perform daily activities, ability to care for family, workplace performance, social obligations, and improved pain control). Alterations in sleep, mood, and libido should also be followed. Several tools are included that may assist with this assessment.
Depression can worsen an individual’s perception of pain and reduce their ability for adaptive coping skills. Depression should be screened for and treated if possible.
Kroenke K, Spitzer R, Williams W, The PHQ-9: Validity of a brief depression severity measure. JGIM, 2001, 16: 606-616.
Reassessment (Brief 4As + Chart Note)
Passik, S. Patient Reassessment Opioid Analgesic 4-A's + Chart Note.