Toronto (Sept. 19, 2012) - Doctors and patients have a new tool to help assess when to use strong painkillers for chronic pain. Opioid Manager™, developed at Toronto Rehab-UHN, is an interactive app for iPhone and iPad that categorizes addiction risk, the main reason doctors hesitate to prescribe certain drugs.

"We know that many family physicians in Ontario – up to 30 percent – are uncomfortable prescribing opioids such as oxycodone to patients experiencing chronic pain; for example, osteoarthritis," says Dr. Andrea Furlan, Toronto Rehab-UHN clinician-scientist who developed the app. "This app helps doctors categorize patients at low, moderate or high risk to decide when to prescribe the opioids that can significantly improve quality of life for low- risk patients."

Lynn Cooper, President of the Canadian Pain Coalition (CPC) and a chronic pain patient, explains that one in five Canadian adults suffer from daily chronic pain. "In 2010, the international pain community established the Declaration of Montreal which states, 'Access to pain management is a fundamental human right' – a right that is not currently being met in Canada," says Ms. Cooper. "For these 6.8 million Canadians, chronic pain is grossly under-managed – Opioid Manager gives me hope that we are moving into an era where the efficient use of practice guideline tools will have significant benefits for people living with pain."

Opioid Manager is interactive and encourages patients to participate in their care. There are four main features:

  • The Initiation Checklist guides physicians through benefits, adverse effects, risks and urine drug screening as needed.
  • The Opioid Risk Tool categorizes each patient by risk of addiction: low-risk candidates have about a six per cent chance of addiction, while high-risk patients have about a 92 per cent risk.
  • The Conversion Calculator shows the morphine equivalent of different opioid drugs, advising doctors on the watchful dose – the dosage at which chronic non-cancer pain can be managed effectively in most patients.
  • The Maintenance and Monitoring Chart lists potential complications, side effects, and behaviours that may signal a patient is becoming addicted.

The app also calculates equivalent dosage when doctors are switching to a different opioid, decreasing dosage, or stopping the use of opioids.

"As we move to a paperless office world, having tools like Opioid Manager immediately at hand will assist physicians in safely and effectively administering opioids," says Dr. Peter Macdougall, Halifax anesthesiologist and Director of Nova Scotia Chronic Pain Collaborative Care Network. "Physicians familiar with electronic information via smartphone or tablet will be very comfortable with it."

Developed in collaboration with Van Le, mobile application consultant and founder, NetFunctional Inc., Opioid Manager is available in the Apple App Store for $9.99. The funds generated from sales will be used to develop My Opioid Manager, a tool to help patients identify risks and assess pain to prepare for their doctor's appointment.

The new app is a technology-based, interactive version of a paper tool, also called Opioid Manager, developed by Dr. Furlan in 2010, with the Centre for Effective Practice in Toronto. The paper tool was endorsed by the Colleges of Physicians and Surgeons in all provinces and territories, and by the Ontario Ministry of Health and Long-Term Care.

Funding to develop the paper tool and app was provided by the Ontario Ministry of Health and Long-Term Care through the Academic Health Science Centre Alternative Funding (AFP) Innovation Fund. U.S. physician Dr. Lynn R. Webster developed the opioid risk tool, included in the Opioid Manager.

Video clip of Dr. Andrea Furlan explaining the Opioid Manager app:

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