May 16, 2021
Written & Researched By: Caleb Dusdal and Thomsen D'hont
The first of the new 105 CCFP Topics https://thegenerehlist.ca/2021/05/16/ccfp-key-topic-chronic-pain/
In a patient with chronic pain: Establish the etiology, Reassess and periodically review the etiology and Periodically look for potential comorbidities or complications, particularly mental illness and addictions.
In a patient with chronic pain who complains of significantly increased pain, search for an alternative etiology as you cannot assume that the original cause of the pain is the reason for the exacerbation.
In a patient in whom you did not make the initial diagnosis of chronic pain: Establish an effective relationship, Verify the diagnosis, and clarify goals of treatment and plans for management
In managing a patient with chronic pain: Use shared decision-making, and engage other professionals in this care when appropriate
In a patient with chronic pain: Comprehensively document the assessment, plan, goals, and prescription details and Make the treatment plan appropriately accessible
When prescribing medications with abuse potential in a patient with chronic pain where you have no established relationship or insufficient records, be prudent in your prescribing. Do not simply provide or refuse to prescribe.
Use a written treatment contract with realistic consequences when prescribing medications with abuse potential to a patient with chronic pain.
When a patient with chronic pain has breached a contract: Manage your own emotions, Address the possible impact on your staff and team, and Apply or judiciously amend the contract