In this episode, Dr. Stader meets Anne, a chronic pain patient new to his practice and they review her medical history. Following their encounter, Don and Rachael discuss the lack of longterm efficacy of opioids for pain management and their safety risks. Show Notes: Opioid Risks and Side Effects The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.
In this episode, Dr. Stader gets to know Anne better and introduces his principles of opioid stewardship to her and how it will look. Following their encounter, Don and Rachael discuss the importance of therapetutic alliance and using evidence-based tools to track her treatment and pain. Show Notes: Compass Opioid Prescribing + Treatment Guidance Toolkit The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.
In this episode, Don and Rachaeldiscuss informed consent and what tools to use for risk stratification and monitoring. Informed Consent and Controlled Substance Agreements Screening Tools for Pain and Opioid Risk Management Risk Management: Putting it All Together The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.
In this episode, Dr. Stader meets again with Anne after reviewing her history and new pain tracking documents and starts to reframe pain to her. Following their encounter, Don and Rachael dive into the biopsychosocial approach and pain psychology. Show Notes: Behavioral Medicine for Pain: Resources for Clinicians and Patients Pain Management Algorithm Nonopioid Pharmacologic Treatments Non-Pharmacologic Treatments The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.
In this episode, Dr. Stader and Anne discuss her medication list and some of their adverse side effects. Following their encounter, Don and Rachael dive into medication risks arising from opioids and certain co-prescribed medications. Show Notes: 2020 Opioid + Sedative Use in COPD Study 2017 Bzd and Z-drug Review The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.
In this episode, Dr. Stader educates Anne about naloxone and why its appropriate in her situation. Following their encounter, Don and Rachael dive into a deeper discusison of harm reduction and how to appropriately broach the subject to patients. Show Notes: Naloxone for Patients on Chronic Opioid Therapy The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.
In this episode, Dr. Stader talks with Anne about her sleep study showing sleep apnea and his concern for her medication regimen contributing to it. Following their encounter, Don and Rachael dive into the nuts and bolts of screening for sleep disordered breathing. Show Notes: 2021 BMJ Article Infographic: Diagnosing Sleep Apnea in Patients Taking Opioids for Chronic Pain The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.
In this episode, Dr. Stader broached his concerns with Anne's medication regimen and they discuss the mechanics of tapering her off some of her medications. Following their encounter, Don and Rachael dive into the collaborative framework for a taper using the BRAVO approach. Show Notes: Optimizing Patient Communication: The Key to a Successful Taper Provider Resources: Patient Communication Skills JAMA 2021 Tapering and Mental Health Article BMJ 2020 Tapering VA Study BRAVO: A Collaborative Approach to Opioid Tapering Opioid Tapering: The Risks and Benefits The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.
In this episode, Dr. Stader and Anne discuss how her taper is going and they agree on some adjustments. Following their encounter, Don and Rachael take a deeper dive into the specific mechanics of tapering fentanyl and Oxycodone. Show Notes: Opioid + Benzodiazepine Tapering How-To Guide Fentanyl 50 mcg TD Taper Example The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.
In this episode, Dr. Stader introduces buprenorphine as a possible agent to help manage Anne's chronic pain. Following their encounter, Don and Rachael discuss the use of buprenorphine for chronic pain and how to effectively cross titrate a patient from other opioids to the safer agent. Show Notes: Buprenorphine and X Waivers IR Opioid Cross Taper to Buprenorphine Example The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.
In this episode, Dr. Stader and Anne chat about how her pain has improved and she is getting more out of life. Following their encounter, Don and Rachael circle back on the 8 pillars of opioid stewardship tying it all together and and talk about modifying the framework to fit individual patients. Show Notes: Benzodiazepine Deprescribing Algorithm Compass Opioid Stewardship Program Compass Opioid Prescribing + Treatment Guidance Toolkit The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.
Summarized DSM-5 diagnostic categories and criteria for opioid use disorder Risks for opioid abuse and dependence among recipients of chronic opioid therapy: results from the TROUP study Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis
Opioid Therapy Risk-Assessment Screening Tools Table Recommended Screening Tools for Pain + Opioid Risk Management Toolkit A Comparison of Common Screening Methods for Predicting Aberrant Drug-Related Behavior among Patients Receiving Opioids for Chronic Pain Management
Risk Mitigation Toolkit
Informed Consent & Controlled Substance Agreement Toolkit
Risk Monitoring Toolkit Aberrancy Management Toolkit
Buprenorphine and X Waivers Toolkit Buprenorphine Protocol Toolkit
Addiction is about giving up everything for one thing. Recovery is about giving up one thing for everything.