The following article is a part of conference coverage from the 2021 American Association of Nurse Practitioners National Conference (AANP 2021), held virtually from June 15 to June 20, 2021. The team at the Clinical Advisor will be reporting on the latest news and research conducted by leading NPs. Check back for more from AANP 2021.
Four resources to support nurse practitioners (NPs) in implementing the Centers for Disease Control and Prevention (CDC) opioid guidelines were highlighted by the CDC’s Loretta Jackson Brown, PhD, RN, CNN, in a poster session at the 2021 American Association of Nurse Practitioners National Conference (AANP 2021).
The CDC provides 2 free, interactive, online training modules for health care providers, including NPs:
- A Nurse’s Call to Action for Safer Opioid Prescribing Practices
- Using the Prescription Drug Monitoring Program to Promote Patient Safety in Opioid Prescribing and Dispensing
The modules are self-paced and participants are rewarded Continuing Education credits upon completion.
The third tool is the CDC’s Quality Improvement and Care Coordination handbook, which is available online and can help NPs integrate the CDC’s guidelines into clinical practice.
The fourth tool is the CDC Opioid Guideline App for use during patient interactions. The free application includes an MME calculator, an interactive interviewing feature, and summarizes key recommendations.
About the Opioid Guidelines
In the United States, overall opioid prescriptions have been declining since 2012, however, the amount of opioids in morphine milligram equivalents (MME) prescribed per person still remains high, Dr. Brown explained. In response to the opioid epidemic, the CDC released the Guideline for Prescribing Opioids for Chronic Pain in 2016.
Dr. Brown highlighted the following 3 main focus areas of the guidelines that promote safer, more effective chronic pain management while reducing the risk for opioid use disorder, overdose, and death:
- Determining when to initiate or continue opioids for chronic pain
- Determining opioid selection, dosage, duration, follow-up, and discontinuation
- Assessing risk for misuse and addressing harms of opioid use
Nurse practitioners’ familiarity with nonopioid and nonpharmacologic therapeutic alternatives for the treatment of chronic pain allows them to educate their patients on appropriate management strategies such that functional pain management goals may be achieved. For cases in which opioids are appropriate, NPs should always consider the potential risks of the therapy to ensure they do not outweigh the potential benefits, Dr. Brown noted.
Nurse practitioners should educate patients on all risks, potential side effects, and interactions associated with opioid therapies. Long-acting or extended-release formulations should be reserved for patients who are experiencing severe, continuous pain, Dr. Brown explained.
When NPs are assessing patients for risks associated with opioid therapy, the CDC recommends identifying potential drug interactions, such as benzodiazepines, that may increase the risk for overdose. States’ prescription drug monitoring programs should be consulted to determine whether patients are receiving duplicate prescriptions. Baseline and ongoing opioid screening are recommended to ensure appropriate opioid use.
“By implementing the CDC guideline recommendations, NPs will improve the safety and effectiveness of pain treatment for their patients by reducing the risk associated with long-term opioid therapy,” Dr. Brown noted.
Editor’s Note: The American Medical Association also recommends education on the safe storage and disposal of opioids. Patients should be reminded that opioid analgesics should be taken only as prescribed; that medications should be kept in a lock-box or other safe location, and not their medicine cabinet, to avoid diversion by visitors, family members, or caregivers. Expired, unwanted, and unused medications should be disposed of “in a local take back or mail back program or medical drop box at a police station, DEA-authorized collection site, or pharmacy.”
Visit Clinical Advisor’s meetings section for complete coverage of AANP 2021. All conference sessions are available to registered attendees through August 31, 2021.
Brown LJ. Applying an evidence-based practice guideline for safer, more effective opioid prescribing for patients with chronic pain. Poster resented at: 2021 American Association of Nurse Practitioners National Conference; June 15-June 20, 2021. Poster 35.