Every day in Australia, 3 people die, and 150 people are hospitalised because of harm from pharmaceutical opioids.
Opioids can be an effective component of the management of acute and cancer-related pain. However, recent evidence shows that for most patients with chronic non-cancer pain, opioids do not provide clinically important improvement in pain or function compared with placebo. Additionally, they carry significant risk of harm; opioid-related harms persist or increase with time and increasing doses.
As part of a new NPS MedicineWise educational program, Opioids, chronic pain and the bigger picture, and the Choosing Wisely Australia initiative, a new resource for people who are prescribed opioids for non-cancer pain in hospital has been developed.
The resource, Managing pain and opioid medicines, was developed in consultation with the Queensland Clinical Senate and Society of Hospital Pharmacists and tested in the surgical wards and emergency departments of four hospitals in Victoria and Queensland, by hospital staff and inpatients. It has three key elements to support people who are prescribed opioids:
- Five questions people are encouraged to ask their health professional before leaving hospital with opioids. This has been modelled on Choosing Wisely Australia’s 5 questions to ask your doctor resource to guide better conversations with health professionals about tests, treatments and procedures.
- Tips for taking and storing opioids at home.
- A personal pain management plan that should be developed in conjunction with a health professional.
Hospital staff are encouraged to provide the two-page patient resource on Managing pain and opioid medicines to people prescribed opioids for non-cancer pain as inpatients, or on discharge and encourage a conversation about opioids use for short-term pain, their adverse effects and other ways of managing pain.
Health professionals practising in primary care are also encouraged to print a copy for their patients and have a discussion about opioids medicines, or patients and carers can download it directly.
Note: The use of opioids in palliative care, to manage symptoms of a life-limiting illness, is not within the scope of this resource.
Choosing Wisely International has fostered a productive collaboration of clinicians, leaders and researchers involved in national campaigns. These have resulted in peer reviewed resources that spread the message of Choosing Wisely and raise awareness about the harms of overuse, along with potential strategies to address this quality problem.
A new Toolkit about engaging patients and the public in Choosing Wisely has been published. It includes brief case studies of patient and public engagement in Choosing Wisely campaigns, including in Australia. Twenty-eight cases from 12 countries describe ways campaigns have partnered, engaged, empowered and informed patients, consumers and the public.
5 questions to ask your doctor or other healthcare provider to make sure you end up with the right amount of care.