The Opioid Monitoring template can be accessed from the analgesia formulary. It can also be found in Auto consultations > Ardens Drug Monitoring J to Z. 

The template is split into 6 tabs; Home, Initiation, Monitoring, Conversion, Opiate Risk Tool and Resources.

Home Tab

To learn more on how to best use the Home tab, please see the our Home Tab Support Article for more details.

Initiation Tab

This tab is split between 3 sections; Assessment, Dose and Status.

Assessment - In this section there are tick boxes to mark that alternative pain management has been optimised along with co-morbidities considered, side effects, risks discussed, drug integrations discussed and dose, route and formulation considered and documented.  There are also drop down boxes for opioid tolerance, aberrant behaviour risk,  indication and goals and the pain score with links to our relevant pain scored assessment templates. 

Links to the Analgesia formulary, Chronic Pain template along with useful links to other relevant templates.

Dose - Opioid commenced tickbox and Opioid and daily dose free text boxes are available in this section.  Here you can record which opioid the patient is taking and their total daily dose by adding together their regular dose and typical 'when required' doses.

Status - Advice and agreement signed codes are available along with a link to the follow up template, an integrated Opioid agreement document and a long term risks document is also available that can be saved in the record under communications and letters.  There is a helpful reminder to discuss the risks of medication that can affect the ability to drive.  

Monitoring Tab

This tab is also split into 3 sections; Assessment, Dose and Status

Assessment - This section allows you to record an Opioid Medication Review with a link to the drug review template.  During that review options are available to record review information such as side effects, interactions, behaviour risk, indication and goals, pain scores along with many other options.  On the righthand side of these codes are template links to the different formularies and applicable scored assessments.

Dose - This has options to document the dosage next steps.

Status - Has the same of the previous tab with advice codes agreement documents and a link to the follow up template.

Opioid Conversion Tab

This tab goes allows you to quickly document the reason for conversion by using the preset notes button.   The workings section guides you through step by step of the calculation for converting from one opioid to another.  

There is a conversion chart in a blue box at the bottom of the page, with morphine equivalences as recommended by the Faculty of Pain Medicine, the BNF and the Scottish Palliative Care Guidelines.  Links to the resources have been included so you can look at the original source for further information if required.  

Opioid Risk Tool Tab

This tab is an at risk state scored assessment going through factors that increase the risk of opioid abuse in patients prescribed opioids for chronic pain.  High risk means the patient is at increased likelihood of future abusive drug-related behaviour and some helpful guidance is included to support these patients.  Answering the questions will automatically code the numerical at risk state of the patient.

Resources Tab

To learn more on how to use the Resources Tab, please see our Using the Resources Tab Support article for more details.

Best Practice Reports

There are also some reports to help monitor patients taking opioid medications.

To find these, go to 'Clinical Reporting > Ardens > Prescribing | Alert > Potentially Addictive.

Pop-Up Alerts

When issuing an opioid prescription, a pop-up will appear if no opioid monitoring has been recorded in the last 6 months and the patient has had:

  • 2 or more issues of an opioid in the last 1 month 
  • 8 or more issues of an opioid in the last 6 months
  • High dose issue of an opioid in the last 6 months

From the pop-up alert, select the 'Review' option to launch the Opioid Initiation and Monitoring template and complete the monitoring. This will supress the alert for 6 months.

Please note:

To stop these pop-up alerts go to Setup > Workflow Support > Protocols > Ardens > Prescribing and deselect the ‘Opioid Monitoring'.

Ardens can also assist with Benzodiazepine + Z-Drug Monitoring