In 2010 the International Association for Hospice and Palliative Care (IAHPC) formed a working committee to determine by consensus the components of an opioid prescription package to be used when initiating a prescription for the control of moderate to severe chronic pain.
The committee developed a study that included a Delphi process among 60 palliative care physicians — from 38 different countries of varying economic levels and diverse geographical regions — from the IAHPC members list. They were asked to rank preferences of drug and dosing schedule for first-line opioid, anti-emetic, and laxative for the treatment of adults with chronic pain due to cancer and other life-threatening conditions.
Using the results from the Delphi process, the committee members developed the Opioid Essential Prescription Package (OEPP) with the appropriate dosage and route of administration for each medication.
IAHPC Opioid Essential Prescription Package (OEPP)
OPIOID
Morphine, oral, 5 mg every 4 hours.
LAXATIVE
-
Combination of senna and docusate, oral, 8.6 mg / 50 mg every 12 hours,
or:
-
Bisacodyl, oral, 5 mg every 12 hours.
ANTIEMETIC
Metoclopramide, oral, 10 mg every 4 hours OR as needed.
Read more about OEPP and the article published in a peer review journal. IAHPC. The IAHPC Opioid Essential Prescription Package (OEPP). Internet. Accessed on August 31, 2016. Available at http://hospicecare.com/resources/palliative-care-essentials/iahpc-opioid-essential-prescription-package/