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 Paper Backup
COT Training Slides
*Intended for classroom use
COT User Guide
*Intended for individual use
COT Recent Changes
- 9 changes for Sep-Dec 2017 update
- Sep-Dec r2 (updated October 2017): Verbiage change for HPV recommendations as listed: https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv.html
- Sep-Dec r2 (updated October 2017): Minor word changes to the PHQ-9 to perfectly mirror the Pfizer Inc. version
- Added the term FIT-DNA to the Preventive Services Recommendation for colorectal cancer screening
- Added a link next to the diabetes CCP for a diabetic foot exam. (The tool is hosted on the tswf-mhs.com website)
- Changed order of screenings on BH/Other tab. PCL-5 now follows GAD-2
- Added 2 contraceptive counseling links above the “Presently Using Birth Control” section
Details: CDC Reproductive Health: https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.html
Mobile app & eBook: eBook Reader App Recommendations for Contraceptive Use and downloaded ebook: https://www.cdc.gov/reproductivehealth/contraception/ebook.html
- Changed “annual” to “biennial” before “Retinal Eye exam done”
- PE Tab: Moved “Accommodation” to the right of the solid line with other exam items not routinely performed
- Moved ”Spleen” and “Abdominal Hernia” to the right of the solid line with other exam items not routinely performed
- 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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