The March/April 2005 commentary article by Gourlay et al. recommending a universal precautions approach in pain medicine may one day be regarded as one of the seminal works in the evolution of the specialty [1]. As stated in the article, the 10 steps of universal precautions in pain medicine should generate further debate, discussion, and discovery within the pain medicine and addiction medicine communities. I had the good fortune of attending Dr. Gourlay's presentation at the April 2004 “Pain & Addiction: Common Threads V” program, held in conjunction with the American Society of …

The COMPLIANCE documentation aid.

Universal precautions: it's not about the molecule!

/pdf/the-compliance-documentation-aid-3akk1ubx5t.pdf

The heightened interest in pain management is making the need for appropriate boundary setting within the clinician-patient relationship even more apparent. Unfortunately, it is impossible to determine before hand, with any degree of certainty, who will become problematic users of prescription medications. With this in mind, a parallel is drawn between the chronic pain management paradigm and our past experience with problems identifying the "at-risk" individuals from an infectious disease model. By recognizing the need to carefully assess all patients, in a biopsychosocial model, including past and present aberrant behaviors when they exist, and by applying careful and reasonably set limits in the clinician-patient relationship, it is possible to triage chronic pain patients into three categories according to risk. This article describes a "universal precautions" approach to the assessment and ongoing management of the chronic pain patient and offers a triage scheme for estimating risk that includes recommendations for management and referral. By taking a thorough and respectful approach to patient assessment and management within chronic pain treatment, stigma can be reduced, patient care improved, and overall risk contained.

http://www.doctordeluca.com/Library/Pain/UniversalPrecautionsForCP05.pdf

The COMPLIANCE documentation aid.

Citations

Universal precautions: it's not about the molecule!

References

Universal Precautions in Pain Medicine: A Rational Approach to the Treatment of Chronic Pain

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