Table 1 Initially generated 29 outcomes by the Definitions Outcomes Group (n = 14)

1. Assessment of pain using a validated pain scale or another validated method

2. Assess function with scale – intended as part of quality of life assessment

3. Prescribing opioids to patients for conditions for which evidence has shown opioids to be effective for management of CNCP

4. Prescribing of opioids at or greater than the watchful dose (200 mg of morphine equivalent per day) for CNCP

5. Discontinuation or tapering in patients experiencing adverse effects or insufficient opioid effectiveness

6. Referral of patients with CNCP to a pain specialist or pain centre

7. Safe initiation of fentanyl during an opioid trial using the “stepped approach” for CNCP

8. Use of meperidine and pentazocine for treating CNCP

9. Number and proportion of CNCP patients who receive non-drug treatments

10. Concomitant prescribing of benzodiazepines and opioids

1. Assessment of patient’s risk of addiction before starting opioid therapy by prescribers, such as use of tools.

2. Ordering of urine drug screening for patients before starting opioids and when monitoring the patient

3. Use of treatment agreements with patients before initiating opioid therapy for CNCP

4. Use of patient information from prescription monitoring programs to monitor patients on opioid therapy for aberrant drug-related behaviours, where available.

5. Clinician response to the detection of aberrant drug-related behaviours in patients on opioid therapy.

6. Referrals to addictions services

7. Methadone/buprenorphine prescribing

8. Monitoring patients on opioid therapy for aberrant drug-related behaviours

9. Acute and urgent health-care facilities’ use of policies to provide guidance on opioid prescribing

Pain

Addictions

1. Amount of weak and strong opioids prescribed by jurisdiction and per patient with CNCP

2. Types and amounts of adjunctive medications prescribed for CNCP patients taking opioids

3. Suicide rates associated with inadequately controlled pain

4. Emergency room visit rates associated with inadequate pain control

5. Effects of CNCP and taking opioids for CNCP on quality of life

1. Prevalence and incidence of prescription opioid addiction

2. Mortality rates associated with prescription opioid overdose

3. Emergency room visit rates associated with prescription opioid overdose

4. Proportion of patients on opioid therapy for CNCP who exhibit aberrant drug-taking behavior

5. Extent of prescription opioid diversion