Compass Opioid Stewardship Clinical Cases

In this episode, Dr. Stader and Anne chat about how her pain has improved and she is getting more out of life. Following their encounter, Don and Rachael circle back on the 8 pillars of opioid stewardship tying it all together and and talk about modifying the framework to fit individual patients.

Show Notes:

Benzodiazepine Deprescribing Algorithm

Compass Opioid Stewardship Program

Compass Opioid Prescribing + Treatment Guidance Toolkit

The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.

In this episode, Dr. Stader introduces buprenorphine as a possible agent to help manage Anne's chronic pain. Following their encounter, Don and Rachael discuss the use of buprenorphine for chronic pain and how to effectively cross titrate a patient from other opioids to the safer agent.

Show Notes:

Buprenorphine and X Waivers

IR Opioid Cross Taper to Buprenorphine Example

The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.

In this episode, Dr. Stader and Anne discuss how her taper is going and they agree on some adjustments. Following their encounter, Don and Rachael take a deeper dive into the specific mechanics of tapering fentanyl and Oxycodone.

Show Notes:

Opioid + Benzodiazepine Tapering How-To Guide

Fentanyl 50 mcg TD Taper Example

The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.

In this episode, Dr. Stader broached his concerns with Anne's medication regimen and they discuss the mechanics of tapering her off some of her medications. Following their encounter, Don and Rachael dive into the collaborative framework for a taper using the BRAVO approach.

Show Notes:

Optimizing Patient Communication: The Key to a Successful Taper

Provider Resources: Patient Communication Skills

JAMA 2021 Tapering and Mental Health Article

BMJ 2020 Tapering VA Study

BRAVO: A Collaborative Approach to Opioid Tapering

Opioid Tapering: The Risks and Benefits

The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.

In this episode, Dr. Stader talks with Anne about her sleep study showing sleep apnea and his concern for her medication regimen contributing to it. Following their encounter, Don and Rachael dive into the nuts and bolts of screening for sleep disordered breathing.

Show Notes:

2021 BMJ Article Infographic: Diagnosing Sleep Apnea in Patients Taking Opioids for Chronic Pain

The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.

In this episode, Dr. Stader educates Anne about naloxone and why its appropriate in her situation. Following their encounter, Don and Rachael dive into a deeper discusison of harm reduction and how to appropriately broach the subject to patients. Show Notes: Naloxone for Patients on Chronic Opioid Therapy The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.

In this episode, Dr. Stader and Anne discuss her medication list and some of their adverse side effects. Following their encounter, Don and Rachael dive into medication risks arising from opioids and certain co-prescribed medications. Show Notes: 2020 Opioid + Sedative Use in COPD Study 2017 Bzd and Z-drug Review The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.

In this episode, Dr. Stader meets again with Anne after reviewing her history and new pain tracking documents and starts to reframe pain to her. Following their encounter, Don and Rachael dive into the biopsychosocial approach and pain psychology. Show Notes: Behavioral Medicine for Pain: Resources for Clinicians and Patients Pain Management Algorithm Nonopioid Pharmacologic Treatments Non-Pharmacologic Treatments The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.

In this episode, Don and Rachaeldiscuss informed consent and what tools to use for risk stratification and monitoring. Informed Consent and Controlled Substance Agreements Screening Tools for Pain and Opioid Risk Management Risk Management: Putting it All Together

The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.

In this episode, Dr. Stader gets to know Anne better and introduces his principles of opioid stewardship to her and how it will look. Following their encounter, Don and Rachael discuss the importance of therapetutic alliance and using evidence-based tools to track her treatment and pain. Show Notes: Compass Opioid Prescribing + Treatment Guidance Toolkit The Iowa Healthcare Collaborative presents the Compass Opioid Stewardship Clinical Cases podcast in partnership with the Centers for Medicare and Medicaid Services. Visit their website for more information on the Compass Opioid Stewardship Program.