New clinical guidelines have been developed by Australian researchers to support doctors in reducing opioid use in their patients.
Published in the Medical Journal of Australia, the evidence-based clinical guidelines will help general practitioners with what is known as “opioid deprescribing”.
Dr Aili Langford, Associate Professor Danijela Gnjidic and Associate Professor Carl Schneider and their colleagues at the University of Sydney have made eleven recommendations providing advice about when and how opioid deprescribing should be considered, and for which patients.
“It is possible to reduce opioid use and harms without worsening pain, whilst maintaining or even improving quality of life. However, pain management should not be one-dimensional,” says Associate Professor Gnjidic.
Dr Langford said their work was prompted by concerns that Australia may have been following the United States and Canada where there are rising rates of inappropriate prescription opioid use (here and here).
“Pain and pain-related conditions are a leading cause of disability and disease burden globally, with one in five adults aged 45 years and over reporting persistent, ongoing pain,” the authors write.
The new guidelines will be vital in providing Australian GPs with support and direction to help curb opioid use in their patients.
“General practitioners are well positioned to conduct opioid deprescribing due to their ongoing relationship with patients, opportunities for shared decision making, and ongoing monitoring and management,” Dr Langford said.
Dr Langford said it is vital for doctors to plan for deprescribing when initially prescribing opioids.
“Opioids can be effective in pain management. However, over the longer-term, the risk of harms may outweigh the benefits,” said Associate Professor Schneider from the School of Pharmacy.
“Our guideline group felt it was vital to recommend that health care professionals plan for deprescribing at the point of initiation.
“This may involve discussions with patients about the expected duration of therapy, goals of care, potential side effects, safe use, storage and disposal, as well as figuring out when and how these medicines will be reduced or discontinued, if appropriate.”
- Sam Hunt