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Quality & Practice Resources / Quality Programs & Guidelines / AAOS Toolkits / Optimizing the Safe and Effective Alleviation of Pain

Optimizing the Safe and Effective Alleviation of Pain

Consider all the factors that affect patients’ ability to get comfortable after injury or surgery. 

  • Identify and address sources of stress (home, finances, relationship, work, etc.), distress (symptoms of anxiety or depression), and less effective coping strategies (low self-efficacy, substantial catastrophic thinking) prior to elective surgery.
  • Consider routine screening to quantify the potential for opioid misuse. Making a screening routine reduces stigma and makes it a more positive aspect of preparing patients for surgery. 
  • Routinely check the Prescription Monitoring Program (PMP) for any recent prescriptions of scheduled medications.
  • Use screening tools to identify opportunities for safe and effective alleviation of pain.
  • Inform the entire surgical team of the findings of the risk assessment. Specifically screen for agonist-antagonist medication use that may have to be stopped before surgery.

Preoperative Screening Tools

Opioid Risk Tool for Narcotic Abuse
Estimates the risk of behaviors related to opioid misuse

Pain Self-Efficacy Questionnaire – Short Form (PSEQ-2)1
Two-question tool to measure the ability to cope with pain. May signal which patients would benefit from a discussion about resilience and coping strategies.

Patient Health Questionnaire 2 (PHQ-2)2
Two question tool to measure symptoms of depression.

The Screener and Opioid Assessment for Patients in Pain
Tool to facilitate assessment and planning for chronic pain in patients being considered for long-term opioid treatment. A shorter 8-question online version is also available.

PDF version of preoperative screening tools. 

SOAPP® is intended for use by licensed health care professionals only, copyrighted by Inflexxion, Inc.

1. Arjan GJ, et al. The creation of an abbreviated version of the PSEQ: the PSEQ-2. Psychosomatics. 2014;55(4):381–385. 2. National Institute on Drug Abuse. Instrument: Patient Health Questionnaire-2 (PHQ-2). https://cde.drugabuse.gov/instrument/fc216f70-be8e-ac44-e040-bb89ad433387. Accessed August 14, 2018. 3. Inflexxion, Inc. Opioid Risk Management. https://www.painedu.org/opioid-risk-%20management/.