The TSWF Chronic Opioid Therapy AIM form is intended to help primary care providers manage their COT patients.
The form is based on the VA/DoD Clinical Practice Guidelines (CPGs) and if used appropriately, will help standardize the management of these patients throughout the military. The COT form only makes use of evidence-based practices and contains all the reference materials and external links needed to treat this extremely complex patient population.
Attention all MHS providers authorized to prescribe controlled substances:
There is mandatory opioid safety training as directed by the 2016 presidential memorandum. If you have not already completed the training, you can find both the memorandum and Prescriber Safety Training here.
Training Material for All Users
AHLTA and other training resources
Additional TSWF support
COT Training Slides
*Intended for classroom use
COT Paper Backup
COT User Guide
*Intended for individual use
Fillable PDF Consent for Long-Term Opioid Therapy for Pain
- Added a clinical cue to the Family History text box (“Including, but not limited to, diabetes, heart disease, HTN, colon cancer, breast cancer, and/other cancers, and conditions that run in the family.”)
- Added a clinical cue to the PHQ-9 ribbon (“If clinical judgement suggests, and/or patient is on anti-depressants and has a history of depression, skip PHQ-2, open ribbon, and go directly to PHQ-9.”)
- Changed ribbon wording to: Depression Screening (PHQ-2 and PHQ-9)
- Renamed the “Sexual Assault Toolkit” ribbon as “Sexual Assault Resources”
- Removed the Overall Health question
- Removed Secure Messaging question from Annual Questions field
- Added REALM SF details and words to the forms (listed individually)
- Placed the REALM SF scoring chart to the right of the text box with instruction:
“The score is based on the number of words correctly read aloud.”
- Consolidated MSK upper and lower into one tab
- Reformatted Red Flags field
- Moved Lifestyle/Exercise questions to Exit CCP tab
- AUDIT-C revision:
-Deleted previous AUDIT-C score field
-Added AUDIT-C score to the existing date field
-Reformatted clinical information
- Deleted the Allergies field and added blue cue text explaining the change
- Developed by pain management specialists
- Helps PCMs manage COT patients
- Contains essential references and links
The number of COT patients in the MHS has increased exponentially in light of the recent conflicts that our soldiers, sailors, and airmen have been involved in throughout the world. The COT form was created as an effort to help primary care providers manage the ever-increasing number of patients in the MHS who need COT to manage their medical conditions.
It is well known that COT patients are not managed in any standardized fashion by primary care providers throughout the MHS. It is also known that primary care providers make up the largest percentage of individuals who prescribe narcotic pain medicines. These facts were recognized by the PCMH board, who made the development of this form their highest priority in 2012-2013. A team of pain management specialists from each service met in December of 2012 and developed this form based on the VA/DoD CPGs. The form was then beta tested and piloted at sites around the world for a year, prior to being made available to the entire MHS.
TSWF COT Form Lead
Mark Kline PA-C MSHS
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