Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice
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...
Published in: | Substance Abuse Treatment, Prevention, and Policy |
---|---|
Main Authors: | , , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Uppsala universitet, Institutionen för farmaceutisk biovetenskap
2018
|
Subjects: | |
Online Access: | http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-362654 https://doi.org/10.1186/s13011-018-0160-7 |
id |
ftuppsalauniv:oai:DiVA.org:uu-362654 |
---|---|
record_format |
openpolar |
spelling |
ftuppsalauniv:oai:DiVA.org:uu-362654 2024-02-11T10:05:13+01:00 Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice Kakko, Johan Gedeon, Charlotte Sandell, Mikael Grelz, Henrik Birkemose, Inge Clausen, Thomas Runarsdottir, Valgerour Simojoki, Kaarlo Littlewood, Richard Alho, Hannu Nyberg, Fred 2018 application/pdf http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-362654 https://doi.org/10.1186/s13011-018-0160-7 eng eng Uppsala universitet, Institutionen för farmaceutisk biovetenskap Umeå Univ, Norrlands Univ Sjukhus, Psykiatriska Klin Umeå, Dept Clin Sci,Psychiat, Umeå, Sweden Solstenen i Skane, Addict Ctr, Lund, Sweden Capio Maria, Stockholm, Sweden; Capio Maria, Skåne, Sweden Lund Univ, Dept Clin Sci, Malmo, Sweden; Skåne Univ Hosp, Pain Rehabil Dept, Skåne, Sweden Misbrugsbehandling, Odense Kommune, Overlaege, Odense, Denmark Univ Oslo, Norwegian Ctr Addict Res, Oslo, Norway Vogur Hosp, SAA Natl Ctr Addict Med, Reykjavik, Iceland Univ Helsinki, A Clin Fdn A Clin Oy, Helsinki, Finland; Helsinki Univ Hosp, Helsinki, Finland Applied Strateg, London, England Univ Hosp, Abdominal Ctr, Helsinki, Finland; Univ Helsinki, Helsinki, Finland Substance Abuse Treatment, Prevention, and Policy, 2018, 13, http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-362654 doi:10.1186/s13011-018-0160-7 PMID 29859110 ISI:000433980900001 info:eu-repo/semantics/openAccess Opioid use disorder Chronic pain Nordics countries Substance Abuse Beroendelära Article, review/survey info:eu-repo/semantics/article text 2018 ftuppsalauniv https://doi.org/10.1186/s13011-018-0160-7 2024-01-17T23:33:36Z 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 Uppsala University: Publications (DiVA) Norway Substance Abuse Treatment, Prevention, and Policy 13 1 |
institution |
Open Polar |
collection |
Uppsala University: Publications (DiVA) |
op_collection_id |
ftuppsalauniv |
language |
English |
topic |
Opioid use disorder Chronic pain Nordics countries Substance Abuse Beroendelära |
spellingShingle |
Opioid use disorder Chronic pain Nordics countries Substance Abuse Beroendelära Kakko, Johan Gedeon, Charlotte Sandell, Mikael Grelz, Henrik Birkemose, Inge Clausen, Thomas Runarsdottir, Valgerour Simojoki, Kaarlo Littlewood, Richard Alho, Hannu Nyberg, Fred 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 Substance Abuse Beroendelära |
description |
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 |
Kakko, Johan Gedeon, Charlotte Sandell, Mikael Grelz, Henrik Birkemose, Inge Clausen, Thomas Runarsdottir, Valgerour Simojoki, Kaarlo Littlewood, Richard Alho, Hannu Nyberg, Fred |
author_facet |
Kakko, Johan Gedeon, Charlotte Sandell, Mikael Grelz, Henrik Birkemose, Inge Clausen, Thomas Runarsdottir, Valgerour Simojoki, Kaarlo Littlewood, Richard Alho, Hannu Nyberg, Fred |
author_sort |
Kakko, Johan |
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 |
Uppsala universitet, Institutionen för farmaceutisk biovetenskap |
publishDate |
2018 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-362654 https://doi.org/10.1186/s13011-018-0160-7 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
Substance Abuse Treatment, Prevention, and Policy, 2018, 13, http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-362654 doi:10.1186/s13011-018-0160-7 PMID 29859110 ISI:000433980900001 |
op_rights |
info:eu-repo/semantics/openAccess |
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 |
_version_ |
1790602115893166080 |