ENROLLED
2017 Regular Session
HOUSE CONCURRENT RESOL UTION NO. 75
BY REPRESENTATIVE WHITE
A CONCURRENT RESOL UTION
To urge and request the Louisiana Department of Health to take all necessary steps to bring
attention to the need to eliminate the use of pain as the fifth vital sign and as a
determinant of quality patient care.
WHEREAS, vital signs are useful in detecting or monitoring medical problems; and
WHEREAS, the four main vital signs routinely monitored by medical professionals
and healthcare providers are body temperature, pulse, respiration rate, and blood pressure;
and
WHEREAS, the idea of evaluating pain as a fifth vital sign has rapidly caught on
nationally and has been adopted by the Veterans Health Administration and the Joint
Commission on Accreditation of Healthcare Organizations, now commonly known as the
Joint Commission; and
WHEREAS, in 1999, in an effort to improve pain management, the Veterans Health
Administration launched the "Pain as the 5th Vital Sign" initiative, requiring a patient-
reported pain intensity rating from zero to ten at all clinical encounters; and
WHEREAS, the Joint Commission subsequently recommended that pain be assessed
in all patients; and
WHEREAS, in 1997, the Federation of State Medical Boards developed model
guidelines to encourage state medical boards and other healthcare regulatory agencies to
adopt policies encouraging the safe and effective treatment of patients with pain including
the use of opioid analgesics; and
WHEREAS, according to the Centers for Disease Control and Prevention, opioid
prescriptions have nearly quadrupled since 1999; and
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WHEREAS, deaths from prescription opioids, including drugs like oxycodone,
hydrocodone, and methadone, have more than quadrupled since 1999; and
WHEREAS, from 1999 to 2015, more than one hundred eighty-three thousand
Americans have died from overdoses related to prescription opioids; and
WHEREAS, overdose is not the only risk related to prescription opioids; and
WHEREAS, in 2014, almost two million Americans abused or were dependent on
prescription opioids; and
WHEREAS, the United States Food and Drug Administration is now recommending
mandatory training for physicians who prescribe opioids; and
WHEREAS, physicians who resist prescribing more narcotics may be adversely
affected if patient satisfaction scores in patient care surveys drop as a result; and
WHEREAS, in June 2016, the American Medical Association House of Delegates
adopted a Board of Trustees report recommending that the association advocate that pain as
the fifth vital sign be removed from professional standards and usage; and
WHEREAS, physicians at the American Academy of Family Physicians 2016
Congress of Delegates voted to eliminate pain scores as the fifth vital sign.
THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby
urge and request the Louisiana Department of Health to take all necessary steps to bring
attention to the need to eliminate the use of pain as the fifth vital sign and a determinant of
quality patient care, and to increase prescriber education and awareness on assessing,
identifying, and treating the symptom of pain with the goal of reducing the use of opioids
to treat patient-reported pain when alternative forms of pain management would be
sufficient.
BE IT FURTHER RESOLVED that the Louisiana Department of Health is hereby
urged to bring this important issue to the attention of the United States Congress, the Centers
for Disease Control and Prevention, the United States Food and Drug Administration,
America's Health Insurance Plans, accrediting organizations including but not limited to the
National Committee on Quality Assurance, the Joint Commission, and the Utilization
Review Accreditation Commission, and the Federation of State Medical Boards, as well as
Louisiana medical schools, prescriber licensing boards, prescriber trade associations, and
other interested stakeholders and policy makers.
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BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the
secretary of the Louisiana Department of Health.
SPEAKER OF THE HOUSE OF REPRESENTATIVES
PRESIDENT OF THE SENATE
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