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Titre du document / Document title

Opioid contracts in chronic nonmalignant pain management : Objectives and uncertainties

Auteur(s) / Author(s)

ARNOLD Robert M. (1) ; HAN Paul K. J. (2) ; SELTZER Deborah (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Medicine, University of Pittsburgh, Pittsburgh, Pa, ETATS-UNIS
(2) Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Md, ETATS-UNIS

Résumé / Abstract

In this article, we review the principal objectives and ideal elements of opioid contracts, as articulated by proponents of the practice. We examine the limited empirical evidence for the effectiveness of opioid contracts in achieving their intended objectives and identify areas of uncertainty and of ethical concern regarding their implementation. We argue that the challenge in deciding about implementing opioid contracts in clinical practice relates to the multiplicity of potential objectives they might serve, to a lack of empirical evidence regarding their effectiveness, and to ethical concerns over their implementation. Specialty and primary care clinicians contemplating the use of opioid contracts in treating patients with chronic nonmalignant pain need to be sensitive to these considerations, and further debate and research is necessary to establish the proper objectives, elements, effectiveness, and ethical justifications of opioid contracts in clinical practice.

Revue / Journal Title

The American journal of medicine    ISSN  0002-9343   CODEN AJMEAZ 

Source / Source

2006, vol. 119, no4, pp. 292-296 [5 page(s) (article)] (28 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1946) (Revue)

Mots-clés anglais / English Keywords

Medicine

;

Uncertainty

;

Clinical management

;

Treatment

;

Pain

;

Chronic

;

Contract

;

Mots-clés français / French Keywords

Médecine

;

Incertitude

;

Conduite à tenir

;

Traitement

;

Douleur

;

Chronique

;

Contrat

;

Mots-clés espagnols / Spanish Keywords

Medicina

;

Incertidumbre

;

Actitud médica

;

Tratamiento

;

Dolor

;

Crónico

;

Contrato

;

Localisation / Location

INIST-CNRS, Cote INIST : 4562, 35400015677017.0010

Nº notice refdoc (ud4) : 17700370



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