PRACTICE PARTNER
further address the management plans by Ontario
doctors. All of the tools below can be found on the
website of the Centre for Effective Practice http://www.
cep.health/. The CPSO’s website also includes links to
these resources and others in order to provide support
and assistance to physicians.
The Management of Chronic Non-Cancer Pain Tool
This tool is designed to assist primary care providers
develop and implement a management plan for adult
patients living with chronic non-cancer pain. This tool
encourages primary care providers, where appropri-
ate, to use a combination of non-pharmacological and
pharmacological options to build a comprehensive and
personalized plan that incorporates the patient’s goals.
The tool reflects recommendations from the 2017
Canadian Guideline for Opioids for Chronic Non-Cancer
Pain and provides supporting materials and resources
for patients and providers.
Clinically Organized Relevant Exam (CORE) Back
Tool
This tool builds from the Ministry of Health and
Long-Term Care Low Back Pain Strategy, which began
in 2012. The goal of this initiative was to reduce the
number of unnecessary diagnostic tests, improve wait
times and enhance patient care. Feedback from primary
care providers about the CORE Back Tool 2012 has
informed revisions to a 2016 update.
Opioid Manager The CORE Neck Tool and Headache Navigator
The Opioid Manager is specifically designed to support
primary care providers prescribe and manage opioids
for patients with chronic non-cancer pain. This is an
update of the original Opioid Manager tool which
includes feedback from primary care providers and
recommendations from the 2017 Canadian Guideline
for Opioids for Chronic Non-Cancer Pain. Headache and neck pain are challenging to treat,
especially when presented together. The CORE Neck
Tool and Headache Navigator was developed to assist
primary care providers in differentiating and assessing
neck pain or headache. Because neck pain and headache
often have overlapping presentation of symptoms, this
tool uses discrete approaches that help rule out other
underlying conditions.
Opioid Tapering Template
This tool recognizes that opioid tapering is a complex
process, and is designed to assist primary care providers
develop tapering plans with their patients and adjust
those plans as their patients’ needs change due to pain,
function and withdrawal symptoms. Throughout the
tool, providers will find helpful talking points, fillable
forms and links to relevant resources including those
created by the CEP as part of its pain management suite
of clinical tools.
Opioid Use Disorder (OUD) Tool
This tool was developed to walk primary care provid-
ers through screening, diagnosing, treating and com-
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municating with patients who have, or are at risk of
developing, OUD. The tool emphasizes a stigma-free
and empathetic approach that acknowledges OUD as
a chronic illness requiring long-term chronic disease
management.
In order to navigate difficult conversations about
opioid misuse, the CEP has included talking points
throughout the tool that address patient education,
safety, expectations and goals.
DIALOGUE ISSUE 1, 2019
Osteoarthritis Tool
The Osteoarthritis Tool was developed for primary care
providers managing patients with new or recurrent joint
pain consistent with osteoarthritis of the hip, knee or
hand. This tool can help clinicians identify symptoms
and provide evidence-based, goal-oriented non-phar-
macological and pharmacological management while
identifying triggers for investigations or referrals.
MD
The CPSO’s website include links to these
resources and others.
www.cpso.on.ca/CPD/resource