Module 5: Monitoring and Evaluation

Lesson 1

Learning outcome

Describe appropriate monitoring and evaluation of patients who are prescribed CDS.

Introduction

Monitoring patients who are prescribed CDS is an essential part of a therapeutic plan. Monitoring incorporates evaluating and balancing the effectiveness of the CDS, the plateauing of benefits, and any adverse effects that may occur. Guidelines exist that support monitoring activity for patients on opioids and other CDS.

Monitoring guidelines from the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain (NOUGG, 2017) support assessment for the effective balancing of three factors:

1. Effectiveness: improved function or at least 30% reduction in pain intensity
2. Plateauing: effectiveness plateaus where increasing the dose yields little benefit
3. Adverse effects/complications: these may be present but they must be manageable