TestSTAT Tools
Opioid therapy should be considered after other strategies have been evaluated. Usually there should be at least a "moderately severe" pain level, defined as ≥5 or 6 on a 10-point scale, and/or pain that interferes with the ability to function at work, school or socially. Both neuropathic and non-neuropathic pain respond to opioid treatment. However, if there is a strong psychological component underlying the pain, opioids may not be indicated.
It has been reported that in patients treated with opioids without history of abuse or addiction rates were about 0.2% for those who were prescreened, versus 5% for those who were not prescreened. TestSTAT researchers plan to develop validation data about the benefits of addiction risk testing using the anonymous data collected as our mainframe computer scores thousands of PMEs over the internet over time. For now, we emphasize the best measures available, in context of many other recognized test tools, which include:
Measures:
• General Health Functioning
• Health Satisfaction
• Height & Weight & BP
• Framingham Heart Study indicators
• Tobacco and Alcohol Questionnaires
• Pain Locale
• Belle Brown degree of Pain Scale
• Neurophysiological Pain Indicators
• Somatoform Pain Measure
• GAD-7
• PHQ-9
• Panic Screen
• PHQ-Anxiety Attack scale
• Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R)
• DSM5 compatible PTSD evaluation
• Health Satisfaction
• Height & Weight & BP
• Framingham Heart Study indicators
• Tobacco and Alcohol Questionnaires
• Pain Locale
• Belle Brown degree of Pain Scale
• Neurophysiological Pain Indicators
• Somatoform Pain Measure
• GAD-7
• PHQ-9
• Panic Screen
• PHQ-Anxiety Attack scale
• Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R)
• DSM5 compatible PTSD evaluation
• Marijuana/hashish Use
• Relevant Medical History
• Sexual, physical abuse victimization
• DSM-5 Cross-Cutting Symptom Measure
• Opioid Risk Tool (ORT)
• CAGE substance abuse screening
• Depression and Anxiety Tests
• Prior Use of and Interest in Traditional vs. Alternative Therapies
• 7-item Instrumental Activities of Daily Living Test
• Screening Intrument for Substance Abuse Potential (SISAP)
• Alcohol Use Disorder Identification Test (AUDIT)
• Pain Catastrophizing Scale (PCS)
• Relevant Medical History
• Sexual, physical abuse victimization
• DSM-5 Cross-Cutting Symptom Measure
• Opioid Risk Tool (ORT)
• CAGE substance abuse screening
• Depression and Anxiety Tests
• Prior Use of and Interest in Traditional vs. Alternative Therapies
• 7-item Instrumental Activities of Daily Living Test
• Screening Intrument for Substance Abuse Potential (SISAP)
• Alcohol Use Disorder Identification Test (AUDIT)
• Pain Catastrophizing Scale (PCS)
Additionally, the Diagnosis, Intractability, Risk, Efficacy (DIRE) interview and the timed Get Up & Go measure can be conducted during an technician assisted testing.
For BP we recommend the new Omron UntraSilent wrist blood pressure monitor, which operates automatically once attached to the patient’s wrist by the technician.
Mental Health Issues in Pain
The PME continues Dr. Spitzer’s work with the PRIME-MD, as it assesses for most common mental disorders: e.g., depressive and anxiety problems; and, alcohol, drug and eating disorders. But, it uses the newest (DSM-5) diagnostic criteria and terminology. Mental health issues can worsen pain and/or substance use disorders, and interfere with outcomes to treatment.
“Therefore, the presence of comorbid psychiatric conditions should be assessed regularly in every patient” with pain.*
Depression has been shown in many studies to worsen other medical conditions and treating anxiety (especially in those with a history of trauma) reduces need for analgesics. An effective pain management program assesses for co-morbid mental conditions.
Combine it all and Document it in a Report
Click here for an example of the report that is emailed directly to the HCP supervising the testing.
Doing such a comprehensive assessment warrants getting paid for it, read on about Reimbursement in the next section. In order for good initial and ongoing assessment to be done, it needs to be reimbursed, just like all other clinical interventions.
Combine it all and Document it in a Report
Click here for an example of the report that is emailed directly to the HCP supervising the testing.
Doing such a comprehensive assessment warrants getting paid for it, read on about Reimbursement in the next section. In order for good initial and ongoing assessment to be done, it needs to be reimbursed, just like all other clinical interventions.
*Center for Substance Abuse Treatment (2005b). Substance abuse treatment for persons with co-occurring disorders. Treatment Improvement Protocol 42. HHS Publication No. (SMA) 05-3922. Rockville, MD: Substance Abuse and Mental Health Services Administration.