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The Ten Steps of Universal Precautions in Pain Medicine. Diagnosis with appropriate differential Psychological assessment including risk of addictive disorders Informed consent (verbal vs written/signed) Treatment agreement (verbal vs written/signed)
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The Ten Steps of Universal Precautions in Pain Medicine • Diagnosis with appropriate differential • Psychological assessment including risk of addictive disorders • Informed consent (verbal vs written/signed) • Treatment agreement (verbal vs written/signed) • Pre/post intervention assessment of pain level and function D Gourlay, HA Heit, A Almahrezi Universal Precautions in Pain Medicine: A Rational Approach to the Treatment of Chronic Pain Pain Medicine. 2005;6(2):107-12
The Ten Steps of Universal Precautions in Pain Medicine • Appropriate trial of opioid therapy +/- adjunctive medication • Reassessment of pain score and level of function • Regularly assess the “Four A’s” of pain medicine • Analgesia, Activity, Adverse effects, & Aberrant behavior* • Periodically review pain diagnosis and comorbid conditions, including addictive disorders • Documentation *Passik SD, Weinreb HJ. Adv Ther. 2000;17(2):70-83
Conclusion • By taking a thorough and respectful approach to patient assessment and management within the context of chronic pain management • Stigma can be reduced • Overall risk contained • Patient care improved • Universal Precautions is not about opioids, it’s about good medical practice