The following are tools clinics can use during chronic pain care visits. We include the the tool, recommended frequency, and relevant references, as available.

Assessment Tools
Tool: Opioid Risk Tool (ORT)

Frequency: Start of opioid therapy

Reference: Webster 2005

Tool: Urine drug test (Interpreting UDT results information sheet)

Frequency: Start of opioid therapy and at least annually, but consider increasing frequency for medium to high-risk patients

References: AMDG Interagency Guideline, CDC Guideline

Tool: State prescription monitoring program (List of PMPs)

Frequency: Start of opioid therapy and at least every 3 months

Tool: Patient Agreement (Model)

Frequency: Start of chronic opioid therapy; annually

Tool: Morphine Equivalent Dose (MED calculator)

Frequency: Every change in opioid prescription

Reference: AMDG

Tool: Pain, Enjoyment, General activity (PEG)

Frequency: Every appointment

Reference: Krebs, 2009

Tool: Patient Health Questionnaire (PHQ)

Frequency: At least every 6 months

Tool: GAD-7 (Generalized Anxiety Disorder)

Frequency: At least every 6 months

Tool: Current Opioid Misuse Measure (COMM)

Frequency: As indicated as a measure of opioid misuse

Reference: Butler, 2007

Tool: Primary Care PTSD Screen (PC-PTSD)

Frequency: If elevated PHQ or GAD despite active treatment

Reference: Prins, 2003

Tool: STOPBang (Screening for obstructive sleep apnea)

Frequency: When co-occurring risks (COPD; restrictive lung disease, including kyphosis or thoracic scoliosis; BMI > 28; snoring; fatigue; witnessed irregular breathing; MED > 50; concurrent use of benzodiazepines)

Reference: Chung, 2012

Tool: Patient self-report survey for the assessment of fibromyalgia

Frequency: As appropriate during diagnosis

Reference: Clauw, 2014