3. Prognosis & Consent

Relay Prognosis and Obtain informed consent

Just like any procedure that has significant risks to the patient, it is ethical to discuss the risks and benefits of opioid analgesic therapy. Patients’ ideas of the benefits and risks of this therapy may be unrealistic or uninformed. Letting the patient know how these medications fit into the comprehensive management (not cure!) of their pain is important to clear up any misconceptions they might have. It may even be helpful to ask them what they think that the benefits and risks of treatment are. Specific issues of addiction, physical dependence, and tolerance should be explored in plain language and presented in a way that the patient can easily understand.

Mr. Hawkins defaultClient Case: Mr. Hawkins

After re-addressing your shared goals for the management of Mr, Hawkins’ chronic back pain, you both agree that a trial of prn opioid pain medication is reasonable.

Knowledge Check

What is your next step in managing Mr. Hawkin’s pain?

Discontinue the meloxicam and cyclobenzaprine and prescribe hydrocodone/acetaminophen 5/325mg every 6 hours as needed for pain Discuss the benefits and risks of short & long-term opioid therapy Add oxycodone extended release 10 mg every 12 hours scheduled for pain Add hydrocodone/acetaminophen 5/325mg TID as needed for pain and schedule a 2 week follow-up visit to re-assess