New CDC opioid prescribing guidelines : improving the way opioids are prescribed for safer chronic pain treatment
Corporate Authors:National Center for Injury Prevention and Control (U.S.). Division of Unintentional Injury Prevention.
Description:The Problem: Existing guidelines vary in recommendations, and primary care providers say they receive insufficient training in prescribing opioid pain relievers. It is important that patients receive appropriate pain treatment, and that the benefits and risks of treatment options are carefully considered.
Improving practice: Improving the way opioids are prescribed through clinical practice guidelines can ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, abuse, or overdose from these powerful drugs.
New Prescribing Guidelines: The Centers for Disease Control and Prevention (CDC) is publishing new opioid prescribing guidelines for chronic pain. The agency is working for timely release of the guidelines while ensuring that the development process:
• Meets scientific standards
• Includes expert consultation
• Allows for appropriate stakeholders to provide input
• Facilitates partnership development to enhance dissemination and uptake
Intended Purpose and Use of Guidelines: The purpose of the CDC guidelines is to provide recommendations for the prescribing of opioid pain relievers for patients 18 and older in primary care settings. Recommendations focus on the use of opioids in treating chronic pain (i.e., pain lasting longer than 3 months or past the time of normal tissue healing) outside end-of-life care.
Clinical practices addressed in the guidelines:
• Determining when to initiate or continue opioids for chronic pain outside end-of-life care
• Opioid selection, dosage, duration, follow-up, and discontinuation
• Assessing risk and addressing harms of opioid use
Guidelines Development: Methods and Processes: CDC used the Grading of Recommendations Assessment, Development, and Evaluation method to guidelines development (www.gradeworkinggroup.org). This method uses a transparent approach to grading quality of evidence and strength of recommendations. Four factors were used to determine the recommendations: 1) quality of evidence, 2) balance between benefits and harms, 3) values and preferences, and 4) costs. CDC also has developed a tiered approach to involve stakeholders in guidelines development.
• Core Expert Group
• Stakeholder Review Group
• Peer Review and Public Comment
• Federal Partner Review
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