When opioid analgesics are prescribed, the effectiveness, appropriateness and ongoing need for opioid analgesic therapy should be regularly reviewed according to the patient’s stage of care. If the opioid analgesic is continued, decisions about the appropriate daily dose of opioid analgesic should be based on the oral morphine-equivalent daily dose (oMEDD) given in the past 24 hours.
During their hospital care, a patient prescribed an opioid analgesic for acute pain should have regular assessment of their pain and function. Due to interpatient variability, the timing of regular assessments should be tailored to the needs of the patient considering the patient’s sedation scores, physical state, ability to move and engagement with active interventions such as physiotherapy.
Consider alternative pain management for patients whose acute pain does not respond to opioid analgesics. This may include changing the opioid analgesic to a non-opioid medicine, nonpharmacological management or referral to other hospital-based support services. These may include specialist services for paediatrics, pain management, drug and alcohol services, clinical pharmacy, or allied health.
If opioid analgesics are being administered intravenously, consider switching to oral opioid analgesic options as soon as the oral route is available.
Ensure review of opioid analgesic treatment occurs immediately before the patient leaves the hospital. The aim of opioid analgesic therapy should be to manage the patient’s acute pain with an opioid analgesic for the shortest duration possible.