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      CDC Clinical Practice Guideline for Prescribing Opioids for Pain United States, 2022

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          Summary

          This guideline provides recommendations for clinicians providing pain care, including those prescribing opioids, for outpatients aged ≥18 years. It updates the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016 (MMWR Recomm Rep 2016;65[No. RR-1]:1–49) and includes recommendations for managing acute (duration of <1 month), subacute (duration of 1–3 months), and chronic (duration of >3 months) pain. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care. The guideline addresses the following four areas: 1) determining whether or not to initiate opioids for pain, 2) selecting opioids and determining opioid dosages, 3) deciding duration of initial opioid prescription and conducting follow-up, and 4) assessing risk and addressing potential harms of opioid use. CDC developed the guideline using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Recommendations are based on systematic reviews of the scientific evidence and reflect considerations of benefits and harms, patient and clinician values and preferences, and resource allocation. CDC obtained input from the Board of Scientific Counselors of the National Center for Injury Prevention and Control (a federally chartered advisory committee), the public, and peer reviewers. CDC recommends that persons with pain receive appropriate pain treatment, with careful consideration of the benefits and risks of all treatment options in the context of the patient’s circumstances. Recommendations should not be applied as inflexible standards of care across patient populations. This clinical practice guideline is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death.

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          Diagnostic and Statistical Manual of Mental Disorders

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            GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.

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              The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.

              A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.
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                Author and article information

                Journal
                MMWR Recomm Rep
                MMWR Recomm Rep
                RR
                MMWR Recommendations and Reports
                Centers for Disease Control and Prevention
                1057-5987
                1545-8601
                04 November 2022
                04 November 2022
                : 71
                : 3
                : 1-95
                Affiliations
                Division of Overdose Prevention, National Center for Injury Prevention and Control, CDC; Office of the Director, National Center for Injury Prevention and Control, CDC; Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
                Author notes
                Corresponding author: Division of Overdose Prevention, National Center for Injury Prevention and Control, CDC. Email: cdcinfo@ 123456cdc.gov .
                Article
                rr7103a1
                10.15585/mmwr.rr7103a1
                9639433
                36327391
                e9c9c0ab-0d1a-4020-9f3c-dc52f558437a

                All material in the MMWR Series is in the public domain and may be used and reprinted without permission; citation as to source, however, is appreciated.

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                Recommendations and Reports

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