Cindy Grande MD, an expert advisor to an important new pain guideline, started her ascent towards reasonable care strategies for pain long before she even began residency in family practice; and navigating the cutting edge is a distinction she achieved before completing residency.

Her achievements excel beyond what many family physicians achieve in their entire careers, including executing data driven quality improvement for pain management, and incorporating principles from anesthesia environments into primary care pain research.

Truly a pioneer in family medicine, Lucinda Grande MD describes her latest work as an expert advisor to the Washington State Agency Medical Directors’ Group (AMDG) 2015 Opioid Dosing Guideline Committee: Why she did it, what she brought to the table, and what others can learn as a result.

A really important resource that I wish I talked more about in our session is the need for access to buprenorphine in primary care, though a simple physician certification process.

-Lucinda Grande, MD

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Interview with Cindy Grande – June 24, 2015

The AMDG updated the Interagency Guideline on Prescribing Opioids for Pain in partnership with a broad advisory group of the state s academic leaders, pain experts, and clinicians in both primary care and specialty areas. The new guideline offers a balanced approach to pain management that includes recommendations for multimodal non-opioid therapies and opioids when appropriate. By using the best practices in the new guideline, clinicians can improve the care of patients with chronic pain and help save lives.

Recent studies support a dose-related risk and shed new light on significant risks occurring at doses lower than 120 mg/day MED. Overdose risk approximately doubles at doses between 20 and 49 mg/day MED, and increases nine-fold at doses of 100 mg/day MED or more.

-2015 AMDG  Opioid Dosing Guideline

The 2015 Interagency Guideline on Prescribing Opioids for Pain now replaces the 2010 Opioid Dosing Guideline. For CME testing purposes, you may continue to use the 2010 CME test on the 2010 Opioid Dosing Guideline until the 2015 CME test is available later in the summer of 2015.

Pioneering Pain Guidelines in Family Practice Cindy Grande MD http://t.co/j2102l3v93 via @manageaddiction @AAFP @CMichaelGibson #ptsafety

Michael Schiesser MD (@manageaddiction) June 25, 2015

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