title: A research-based guideline for appropriate use of transdermal fentanyl to treat chronic pain.
abstract: OBJECTIVE
  To describe a research utilization project intended to develop, implement, and evaluate a research-based guideline for the use of transdermal fentanyl.
  
  
  METHODS
  The guideline was based on existing literature, clinical expert knowledge, manufacturer recommendations, and cost considerations. Principles of guideline development and evaluation were based on recommendations from the Agency for Health Care Policy and Research.
  
  
  RESULTS
  A comparison of data from baseline to six months after guideline implementation revealed improvements in all criteria. Most of the improvements were maintained at 18 months postguideline implementation.
  
  
  CONCLUSIONS
  The guideline improved the appropriate use of transdermal fentanyl. Ongoing education and monitoring is necessary to maintain change in practice.
  
  
  CONCLUSIONS
  The cost-effective use of expensive technology is a concern in the area of health care. Nurses need to promote the appropriate use of pain-management techniques to provide quality care for patients with chronic pain. Guidelines will help nurses to support the use of higher-cost medications in this subpopulation of patients.
authors.affiliation: Department of Veterans Affairs Medical Center, Iowa City, USA.
authors.forename: B
authors.initials: B
authors.lastname: Wakefield
authors.forename: J A
authors.initials: JA
authors.lastname: Johnson
authors.forename: J
authors.initials: J
authors.lastname: Kron-Chalupa
authors.forename: L
authors.initials: L
authors.lastname: Paulsen
mesh_terms: D000279:Administration, Cutaneous; D000701:Analgesics, Opioid / Q000191:economics / Q000627:therapeutic use*; D002908:Chronic Disease; D016527:Drug Costs; D019317:Evidence-Based Medicine; D005283:Fentanyl / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D010146:Pain / Q000188:drug therapy*; D018579:Patient Selection; D017410:Practice Guidelines as Topic / Q000592:standards*; D012189:Retrospective Studies; D013810:Therapeutic Equivalency; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl