16 May Building GP confidence in multimodal pain management might be best way to prevent more prescription opioid related deaths
17 May 2018
Building GP confidence in multimodal pain management might be best way to prevent more prescription opioid related deaths
Research hot off the press from Australian Prescriber outlines how the new paradigm of holistic chronic pain care as delivered in specialist centres may translate into time-poor general practice.
A GP-led multi-disciplinary team describes simple changes in GP practice that may improve pain care and reduce opioid related harms to patients and the community.
The researchers detail how chronic pain education for GPs has been mainly funded by commercial sources, leading to an over-reliance on pharmaceuticals despite their lack of benefit for the majority of patients.
The use of strategies usually associated with rehabilitation or psychological and behavioural care will equip GPs to improve the pain outcomes of their patients while avoiding the risks associated with opioids.
The findings are particularly pertinent given continued alarming increases in opioid related overdoses in NSW. A coronial inquest is currently investigating a series of six overdose deaths in NSW involving opiates in just one month last year.
Dr Simon Holliday, first author of the article, is an addiction physician and a rural GP who saw an opportunity to reduce harm caused due to doctors’ prescribing habits.
“For the last decade or so we have seen prescription opioids, rather than heroin, as the cause of opioid-related presentations to addiction clinics, to emergency departments and to the morgues,” said Dr Holliday.
“Our previous research has shown that merely educating GPs to stop providing quick fixes to complex pain problems does not reduce opioid provision. This project is designed to empower GPs to offer excellent multimodal pain care and encourage non-judgmental opioid care. GPs should not delay opioid tapering until they identify behaviours and attitudes usually seen in illicit heroin users,” said Dr Holliday.
Researchers say the proactive pain management approach in general practice begins at reception. Strategies include refusing phone scripts, encouraging patients to maintain their relationship with their GP and displaying a sign about the practice’s opioid policy.
ScriptWise CEO Bee Mohamed says the research is another example that more must be done to provide education for health professionals and the public about the quality use of prescription opioids.
ScriptWise launched its inaugural National Prevention of Prescription Medication Dependence Week (May 14-18) on Monday to raise community awareness about this issue and advocate for a national public awareness campaign.
“More Australians need to understand that using prescription opioids for as little as one week doubles the risk of long-term use at one year,” said Ms Mohamed.
“There is a perception in the community that because these medications have been prescribed, they are safe to use long-term, but we know that isn’t the case.”
“We need to see the NSW government step up and implement evidence-based strategies, such as rolling out accessible pain and addiction care, real-time prescription monitoring and an awareness campaign about the risks of prescription opioid to prevent further harm in communities,” she said.
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‘Prescribing wellness: comprehensive pain management outside specialist services’ by Simon Holliday, Chris Hayes, Lester Jones, Jill Gordon, Newman Harris, and Michael Nicholas can also be accessed here: https://www.nps.org.au/australian-prescriber/articles/prescribing-wellness-comprehensive-pain-management-outside-specialist-services
Also listen to the podcast: https://www.nps.org.au/australian-prescriber/podcast#e24