Chronic Pain Agreements

Chronic pain is increasingly common in the primary care setting. It is therefore essential for primary care nurse practitioners to be confident managing and treating patients with chronic non-cancer-related pain. One hundred people die every day from drug overdoses in the United States and a majority of these deaths are from prescription drugs. Using the Chronic Care Model as a guiding framework, this paper evaluates the literature to identify evidence-based elements that should be included in a pain management agreement for patients being treated for chronic, non-cancer pain. Pain agreements, while not completely studied for effectiveness and outcomes, are commonly used in primary care settings when opioids are prescribed for patients with chronic pain. Pain agreements between primary care nurse practitioners and patients generally include urine drug screening, assessments to identify psychological comorbidities and Morphine Equivalent Dosing. More research on the impact of pain agreements on patient outcomes is needed