Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice
Abstract Background Long-term use of opioid analgesics (OA) for chronic pain may result in opioid use disorder (OUD). This is associated with adverse outcomes for individuals, families and society. Treatment needs of people with OUD related to chronic pain are different compared to dependence relate...
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ftdoajarticles:oai:doaj.org/article:f0a84ea5f7924e99aa9dbc52fc4e04cb 2023-05-15T16:52:09+02:00 Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice Johan Kakko Charlotte Gedeon Mikael Sandell Henrik Grelz Inge Birkemose Thomas Clausen Valgerður Rúnarsdóttir Kaarlo Simojoki Richard Littlewood Hannu Alho Fred Nyberg 2018-06-01T00:00:00Z https://doi.org/10.1186/s13011-018-0160-7 https://doaj.org/article/f0a84ea5f7924e99aa9dbc52fc4e04cb EN eng BMC http://link.springer.com/article/10.1186/s13011-018-0160-7 https://doaj.org/toc/1747-597X doi:10.1186/s13011-018-0160-7 1747-597X https://doaj.org/article/f0a84ea5f7924e99aa9dbc52fc4e04cb Substance Abuse Treatment, Prevention, and Policy, Vol 13, Iss 1, Pp 1-9 (2018) Opioid use disorder Chronic pain Nordics countries Public aspects of medicine RA1-1270 Social pathology. Social and public welfare. Criminology HV1-9960 article 2018 ftdoajarticles https://doi.org/10.1186/s13011-018-0160-7 2022-12-31T06:22:01Z Abstract Background Long-term use of opioid analgesics (OA) for chronic pain may result in opioid use disorder (OUD). This is associated with adverse outcomes for individuals, families and society. Treatment needs of people with OUD related to chronic pain are different compared to dependence related to use, and also injection, of illicit opioids. In Nordic countries, day-to-day practical advice to assist clinical decision-making is insufficient. Aim To develop principles based on expert clinical insights for treatment of OUD related to the long-term use of OA in the context of chronic pain. Methods Current status including an assessment of barriers to effective treatment in Finland, Denmark, Iceland, Norway, Sweden was defined using a patient pathway model. Evidence to describe best practice was identified from published literature, clinical guidelines and expert recommendations from practice experience. Results Availability of national treatment guidelines for OUD related to chronic pain is limited across the Nordics. Important barriers to effective care identified: patients unlikely to present for help, healthcare system set up limits success, diagnosis tools not used, referral pathways unclear and treatment choices not elucidated. Principles include the development of a specific treatment pathway, awareness/ education programs for teams in primary care, guidance on use of diagnostic tools and a flexible treatment plan to encourage best practice in referral, treatment assessment, choice and ongoing management via an integrated care pathway. Healthcare systems and registries in Nordic countries offer an opportunity to further research and identify population risks and solutions. Conclusions There is an opportunity to improve outcomes for patients with OUD related to chronic pain by developing and introducing care pathways tailored to specific needs of the population. Article in Journal/Newspaper Iceland Directory of Open Access Journals: DOAJ Articles Norway Substance Abuse Treatment, Prevention, and Policy 13 1 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Opioid use disorder Chronic pain Nordics countries Public aspects of medicine RA1-1270 Social pathology. Social and public welfare. Criminology HV1-9960 |
spellingShingle |
Opioid use disorder Chronic pain Nordics countries Public aspects of medicine RA1-1270 Social pathology. Social and public welfare. Criminology HV1-9960 Johan Kakko Charlotte Gedeon Mikael Sandell Henrik Grelz Inge Birkemose Thomas Clausen Valgerður Rúnarsdóttir Kaarlo Simojoki Richard Littlewood Hannu Alho Fred Nyberg Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice |
topic_facet |
Opioid use disorder Chronic pain Nordics countries Public aspects of medicine RA1-1270 Social pathology. Social and public welfare. Criminology HV1-9960 |
description |
Abstract Background Long-term use of opioid analgesics (OA) for chronic pain may result in opioid use disorder (OUD). This is associated with adverse outcomes for individuals, families and society. Treatment needs of people with OUD related to chronic pain are different compared to dependence related to use, and also injection, of illicit opioids. In Nordic countries, day-to-day practical advice to assist clinical decision-making is insufficient. Aim To develop principles based on expert clinical insights for treatment of OUD related to the long-term use of OA in the context of chronic pain. Methods Current status including an assessment of barriers to effective treatment in Finland, Denmark, Iceland, Norway, Sweden was defined using a patient pathway model. Evidence to describe best practice was identified from published literature, clinical guidelines and expert recommendations from practice experience. Results Availability of national treatment guidelines for OUD related to chronic pain is limited across the Nordics. Important barriers to effective care identified: patients unlikely to present for help, healthcare system set up limits success, diagnosis tools not used, referral pathways unclear and treatment choices not elucidated. Principles include the development of a specific treatment pathway, awareness/ education programs for teams in primary care, guidance on use of diagnostic tools and a flexible treatment plan to encourage best practice in referral, treatment assessment, choice and ongoing management via an integrated care pathway. Healthcare systems and registries in Nordic countries offer an opportunity to further research and identify population risks and solutions. Conclusions There is an opportunity to improve outcomes for patients with OUD related to chronic pain by developing and introducing care pathways tailored to specific needs of the population. |
format |
Article in Journal/Newspaper |
author |
Johan Kakko Charlotte Gedeon Mikael Sandell Henrik Grelz Inge Birkemose Thomas Clausen Valgerður Rúnarsdóttir Kaarlo Simojoki Richard Littlewood Hannu Alho Fred Nyberg |
author_facet |
Johan Kakko Charlotte Gedeon Mikael Sandell Henrik Grelz Inge Birkemose Thomas Clausen Valgerður Rúnarsdóttir Kaarlo Simojoki Richard Littlewood Hannu Alho Fred Nyberg |
author_sort |
Johan Kakko |
title |
Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice |
title_short |
Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice |
title_full |
Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice |
title_fullStr |
Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice |
title_full_unstemmed |
Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice |
title_sort |
principles for managing oud related to chronic pain in the nordic countries based on a structured assessment of current practice |
publisher |
BMC |
publishDate |
2018 |
url |
https://doi.org/10.1186/s13011-018-0160-7 https://doaj.org/article/f0a84ea5f7924e99aa9dbc52fc4e04cb |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
Substance Abuse Treatment, Prevention, and Policy, Vol 13, Iss 1, Pp 1-9 (2018) |
op_relation |
http://link.springer.com/article/10.1186/s13011-018-0160-7 https://doaj.org/toc/1747-597X doi:10.1186/s13011-018-0160-7 1747-597X https://doaj.org/article/f0a84ea5f7924e99aa9dbc52fc4e04cb |
op_doi |
https://doi.org/10.1186/s13011-018-0160-7 |
container_title |
Substance Abuse Treatment, Prevention, and Policy |
container_volume |
13 |
container_issue |
1 |
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1766042309647925248 |