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Клиническая поддержка, инструменты и рекомендации

Команда CIAO собрала эти ресурсы для поддержки академических специалистов, поставщиков первичной медико-санитарной помощи и всех, кто участвует в лечении пациентов с хронической болью и которые используют опиоиды. Мы надеемся, что эта страница послужит ресурсом для поиска полезной клинической документации, руководства и инструментов для поддержки принятия клинических решений и лечения пациентов в отношении лечения опиоидами и хронической боли.

Клиническая поддержка поставщиков услуг

UCSF Substance Use Warmline: Free, confidential, peer-to-peer consultation from physicians, clinical pharmacists, and nurses with expertise in substance use evaluation and management for clinicians across the nation.

  • Monday – Friday, 9 a.m. – 8 p.m. ET

  • (855) 300-3595

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California Substance Use Line: Staffed by experienced physicians and pharmacists who can answer confidential questions about substance use evaluation and management, including medications to treat opioid use disorder, the California Substance Use Line provides fast, reliable, patient-tailored guidance and resources to facilitate substance use prevention and treatment efforts for California-based clinicians.

  • Open 24 hrs a day, 7 days a week 

  • (844) 326-2626

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California Bridge: Develops hospitals and emergency rooms into primary access points for substance use disorder treatment. The program provides training and technical assistance to acute care providers to encourage patients to enter and remain in treatment.

  • Resources page: CA Bridge lists a variety of resources related to substance use management, treatment, and care. Resources are included for clinicians, patients, and substance use navigators.

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A patient-centered, rapid access approach to substance use disorders: Recommendations to help clinicians provide rapid, low-threshold, and patient-centered substance use disorder treatment.​

Клинические инструменты для поставщиков (управление опиоидами, постепенное снижение дозы и MOUD)

Pain, Enjoyment, General activity (PEG) scale (pdf): A simple 3-question tool for addressing pain intensity and interference.

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Opioid Management

Clinical Opioid Withdrawal Scale (COWS) (pdf): 11-item scale administered by a clinician to determine the stage and severity of opiate withdrawal. 

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Opioid risk tool: A brief, self-report screening tool designed to assess the risk of developing an opioid use disorder among patients being considered for or already receiving a prescription opioid for pain relief in primary care settings.  

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CDC Opioid Overdose Clinical Tools for Primary Care Providers: A set of clinical tools from the CDC to help primary care providers carry out the complex task of balancing pain management with the potential risks that prescription opioids pose.

 

Working With HIV Clinics to Adopt Addiction Treatments Using Implementation Facilitation (WHAT-IF?) Toolkit: Resources and websites for any  HIV or primary care clinic seeking to integrate treatments for Tobacco, Alcohol, Opioid, and other substance use disorders into their clinical practice and care models.

 

MME Conversion Table: Tool for calculating milligram morphine equivalents (MME) for opioids. 

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GlobalRPH: Provides medical calculators and clinical resources to clinicians related to in drug therapy.

 

Transforming Opioid Prescribing in Primary Care (myTOPCARE): Resources for a novel system change in delivery of primary care services to decrease prescription opioid misuse for patients with chronic pain.

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Opioid Tapering

Veteran's Health Administration: Opioid taper decision tool (pdf): Designed to assist primary care providers in determining if an opioid taper is necessary, in performing the taper, and in providing follow-up and support during the taper. 

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Impact of Transitioning from Long-Term to Intermittent Opioid Therapy on the Development of Opioid-Related Adverse Outcomes: A Retrospective Cohort Study

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CDC Pocket Guide: Tapering Opioids for Chronic Pain (pdf)

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Medications of Opioid Use Disorder 

Acute Pain and Perioperative Management in Opioid Use Disorder: Pain control in patients on buprenorphine, methadone, or naltrexone (pdf)

 

Buprenorphine home induction guides:

 

Opioid Treatment Program Directory by State​​

Клинические рекомендации

Руководство CDC по назначению опиоидов при хронической боли :обновленные рекомендации CDC по состоянию на 2022 год.

DEA: Электронное назначение контролируемых веществ (EPCS) : (расположено в середине страницы).

SAMHSA: Часто задаваемые вопросы: Предоставление метадона и бупренорфина в условиях чрезвычайной ситуации, связанной с COVID-19 (апрель 2020 г.) (pdf)

Информация и поддержка по приему лекарств во время беременности и грудного вскармливания : содержит важные ресурсы, касающиеся использования опиоидов во время беременности и грудного вскармливания, в том числе ссылки на наши основанные на фактических данных информационные бюллетени.

Академическая детализация для улучшения профилактики передозировки: руководство по внедрению для организаций:   Это руководство было разработано совместно с NaRCAD, чтобы помочь государственным и местным департаментам здравоохранения, общественным организациям и другим исполнителям программ планировать, внедрять и оценивать академическую детализацию для поддержки их усилий по профилактике передозировок.

Управление опиоидами (предложения по документации, соглашения о контролируемых веществах, информация CSMP/PDMP и т. д.)

Opioids for Chronic Pain: Documentation Template: A template and example of a medical chart for a clinician documenting their decision-making rationale when treating patients with chronic pain and who use opioids.

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Example Epic SmartPhrase for Comprehensive Assessment of Chronic Pain Treated with Opioids

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Controlled substance agreement templates

Drugabuse.gov: Includes two sample patient agreement forms that can be used with patients who are beginning long-term treatment with opioid analgesics or other controlled substances. ​​

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Prescription Drug Monitoring Programs Evaluation: A Systematic Review of Reviews: A systematic review to describe and identify the methods and outcome measures used to evaluate PDMPs, and summarize existing evidence on outcomes and factors that influence PDMP success or benefit realization.

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Controlled Substance Monitoring Programs (CSMP/PDMP)

California’s Controlled Substance Monitoring Program (CURES):

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Prescription Drug Monitoring Training and Technical Assistance Center: A comprehensive array of services, support, resources, and strategies to PDMPs, federal partners and other stakeholders to further the efforts and effectiveness of PDMPs.

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