The “6As” framework, originally developed for chronic pain management and later adapted for various aspects of healthcare including opioid monitoring, provides a structured approach for evaluating the effectiveness of pain treatment and the patient’s adherence to the treatment plan. In the context of opioid therapy for chronic pain, this model helps in assessing and documenting important aspects of patient care. The 6As are:
- Analgesia:
- This refers to the level of pain relief achieved with opioids.
- The doctor assesses how effectively the opioids are controlling the patient’s pain.
- This often involves asking the patient to rate their pain using a standardized tool like a pain scale.
- Adherence:
- Assesses the patient’s compliance with the prescribed opioid regimen and other aspects of the treatment plan, including the use of non-opioid therapies and lifestyle modifications.
- Adverse Effects:
- Monitoring for adverse effects is crucial in opioid therapy.
- This involves regularly assessing the patient for common side effects of opioids, such as constipation, nausea, sedation, cognitive impairment, and respiratory depression, among others.
- Affect:
- This refers to the patient’s mood and mental health, which are important to consider in chronic pain management.
- Chronic pain can be associated with conditions like depression or anxiety, and opioid use can also affect mood and mental health.
- Assessing affect involves evaluating the patient’s overall psychological well-being and identifying any need for additional mental health support or intervention.
- Activities of Daily Living:
- This aspect assesses the impact of opioid therapy on the patient’s everyday function.
- It includes evaluating whether the treatment helps the patient to improve or maintain their ability to perform daily tasks, work, engage in social activities, and maintain a general quality of life.
- Aberrant Drug-Related Behaviors:
- This involves assessing for behaviors that may indicate misuse, abuse, or addiction.
- These can include behaviours like requests for early refills, lost or stolen prescriptions, unsanctioned dose escalations, or obtaining opioids from multiple sources.
This framework is part of a comprehensive approach to opioid therapy, ensuring that it is used safely and effectively, with a clear focus on improving the patient’s functional status and quality of life, while minimizing risks. Regular review using the 6As can help in making informed decisions about continuing, modifying, or discontinuing opioid therapy.