American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a key component of managing long-term opioid therapy for chronic noncancer pain?

1. Regular consultation with a psychologist

2. Adherence monitoring through prescription surveillance

3. Monthly drug tests to determine effectiveness

4. Full cessation of opioid therapy every six months

The correct answer is: Adherence monitoring through prescription surveillance

In the context of managing long-term opioid therapy for chronic noncancer pain, adherence monitoring through prescription surveillance is essential. This practice involves tracking how patients use their prescribed medications and ensuring they adhere to the treatment plan. It helps identify any potential misuse or abuse of opioids, which is a critical consideration given the risk of addiction and dependency associated with these drugs. Monitoring can be accomplished through various means, such as prescription drug monitoring programs (PDMPs), which provide data on patients' prescription histories and can alert healthcare providers to concerning trends, such as obtaining prescriptions from multiple providers. This approach emphasizes patient safety and informed clinical decision-making, aiming to provide effective pain management while minimizing risks. Other methods mentioned, like regular consultations with a psychologist or monthly drug tests, can support management but are not universally necessary or foundational to opioid therapy for chronic pain. Similarly, the practice of full cessation of therapy every six months is not widely supported in clinical guidelines and could disrupt pain management unnecessarily. Therefore, adherence monitoring stands out as a core component in the responsible management of long-term opioid use.