Date of renewal of patient agreement (signed by patient) |
Current morphine medication equivalent dose of opioid medications |
Date of most recent PDMP check |
Date and result most recent urine drug screen |
PEG scores (trended at regular intervals) |
Opioid risk tool score |
Medication list reviewed for concurrent use of sedatives |
PHQ screen for depression |
PDMP, prescription drug monitoring program; PEG, pain, enjoyment, general activity; PHQ, patient health questionnaire.