scholarly journals Meeting Physician Compliance Recommendations in the Management of Opioids in Chronic Pain: The Chronic Pain Management Registry (CPMR)

2019 ◽  
Vol 10 (1) ◽  
pp. 13
Author(s):  
Paul Langley

In a recent commentary in INNOVATIONS in Pharmacy, details were given on a recently released Chronic Pain Management Registry (CPMR). The CPMR was designed to provide a tracking and audit framework for evaluating claims made for therapy interventions in chronic pain management. At the same time, the CPMR was seen as a key element in monitoring physician and practice compliance with requirements for the prescribing of opioids and other scheduled substances. The purpose of the present commentary is to expand upon the role of the CPMR in the management of opioids in detailing the concordance of the CPMR data collection requirements with the latest recommendations of the American Society of Interventional Pain Physicians (ASIPP) for responsible, safe and effective opioid prescribing in chronic non-cancer pain. Given ongoing concerns with opioid misuse and abuse, the opioid epidemic, physician practices are at risk for what may be judged as poor therapy decisions in evaluating medical necessity and a failure to monitor effectively response to therapy. Adoption of a platform such as the CPMR may, through providing a comprehensive evidence base and tracking capability, support more effective prescribing decisions and adherence to therapy.  At the same time, the ability to justify decisions through a CPMR documentation audit may not only alleviate physician concerns if their decisions are challenged but also lead to improved outcomes in the treatment of chronic pain.    Article Type: Commentary

2019 ◽  
Vol 10 (1) ◽  
pp. 11
Author(s):  
Paul Langley

Previous commentaries in the Formulary Evaluation section of INNOVATIONS in Pharmacy have pointed to the difficulties of establishing the credibility of trial-based and modeled claims for therapy interventions. Claims for interventions in the management of chronic pain are no exception. To meet this challenge, the Chronic Pain Management Registry (CPMR) has been designed to provide an evidence base for physician practices and health care decision makers to evaluate the impact of pain management interventions. The purpose of this commentary is to detail the development, structure and content of the CPMR in two versions: (i) a patient response version and (ii) a combined patient/provider response version. The CPMR has a potentially critical role to play in providing a framework for the effective auditing of practice compliance in the prescribing and monitoring of opioids in the management of chronic pain. The CPMR tracks, with on-line input from the patient and the treating physician, the process and outcomes of therapy interventions. These reports cover the overall pain experience of patients as well as pain intensity and functional status by eleven specific pain locations, covering both pharmacological and non-pharmacological interventions. Prior to each practice visit patients complete reports which are entered to the CPMR with a summary transmitted to the physician practice. Over time, these reports track the cumulative response to therapy as well as the perception of the patients as to whether or not the therapy has led to any substantive improvement in activity limitations, symptoms and quality of life. A particular focus of the CPMR is on monitoring and evaluating the experience with, and impact of opioid medications, to include the effectiveness of opioid formulations on reducing pain intensity and improving functional status, including an intensive assessment of the potential for and experience of opioid substance abuse for individual patients. The CPMR can also support monthly reports to the practice to summarize patient throughput, the response to care by target pain patients and profiles of opioid use and abuse. The CPMR can be customized to meet the needs of individual practices.   Article Type: Commentary


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