Swipe om te navigeren naar een ander artikel
The online version of this article (https://doi.org/10.1007/s11136-018-1941-1) contains supplementary material, which is available to authorized users.
Long-term opioid use for chronic pain has increased, but limited evidence exists on its benefits. Evaluation of long-term benefits in pain is based on patient-reported measures such as health-related quality of life (HRQoL). This study examined the long-term effects of opioid use on HRQoL and its subdomains in patients with back pain or arthritis by comparing opioid users to non-opioid users for three metrics: (1) any opioid use, (2) duration of opioid use, and (3) average daily morphine equivalent dose.
A nationally representative sample of cancer-free adults with chronic back pain or arthritis was selected. Using the 12-Item Short Form Survey, HRQoL measures of Mental Component Score (MCS), Physical Component Score (PCS), and individual subdomains were assessed at baseline and 1 year later. Opioid users were matched to non-opioid users in a 1:1 greedy match using propensity scores estimated based on many patient demographics and baseline HRQoL measures.
At year one, PCS was significantly lower among opioid users, mostly driven by bodily pain subdomain; MCS was not different. Short-term opioid users (< 1 month) had higher MCS while long-term users (≥ 1 month) had lower PCS. Low-dose [< 20 morphine milligram equivalents (MME)/day] opioid use was associated with lower PCS, while no difference was found between high dose (≥ 20 MME/day) and non-opioid users. However, most differences were not clinically significant.
Long-term opioid use is not associated with improvements in HRQoL. Clinicians should carefully evaluate the need for opioid use, especially long-term use in managing chronic back pain and arthritis.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Hootman, J. M., Helmick, C. G., Barbour, K. E., Theis, K. A., & Boring, M. A. (2016). Updated projected prevalence of self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitation among US adults, 2015–2040. Arthritis & Rheumatology (Hoboken, N.J.), 68(7), 1582–1587. https://doi.org/10.1002/art.39692. CrossRef
Freburger, J. K., Holmes, G. M., Agans, R. P., Jackman, A. M., Darter, J. D., Wallace, A. S., et al. (2009). The rising prevalence of chronic low back pain. Archives of Internal Medicine, 169(3), 251–258. https://doi.org/10.1001/archinternmed.2008.543. CrossRefPubMedPubMedCentral
Landsman-Blumberg, P. B., Katz, N., Gajria, K., D’Souza, A. O., Chaudhari, S. L., Yeung, P. P., et al. (2017). Health care resource use and cost differences by opioid therapy type among chronic noncancer pain patients. Journal of Pain Research, 10, 1713–1722. https://doi.org/10.2147/JPR.S130913. CrossRefPubMedPubMedCentral
Zamora-Legoff, J. A., Achenbach, S. J., Crowson, C. S., Krause, M. L., Davis, J. M., & Matteson, E. L. (2016). Opioid use in patients with rheumatoid arthritis 2005–2014: A population-based comparative study. Clinical Rheumatology, 35(5), 1137–1144. https://doi.org/10.1007/s10067-016-3239-4. CrossRefPubMedPubMedCentral
Mafi, J. N., McCarthy, E. P., Davis, R. B., & Landon, B. E. (2013). Worsening trends in the management and treatment of back pain. JAMA Internal Medicine, 173(17), 1573. https://doi.org/10.1001/jamainternmed.2013.8992. CrossRefPubMedPubMedCentral
Chaparro, L. E., Furlan, A. D., Deshpande, A., Mailis-Gagnon, A., Atlas, S., & Turk, D. C. (2014). Opioids compared with placebo or other treatments for chronic low back pain. Spine, 39(7), 556–563. https://doi.org/10.1097/BRS.0000000000000249. CrossRefPubMed
Chou, R., Rick Deyo, F., Beth Devine, M., Ryan Hansen, R., Sullivan, S., Jarvik, J. G., et al. (2014). The effectiveness and risks of long-term opioid treatment of chronic pain. Rockville, MD: Agency for Healthcare Research and Quality (US). CrossRef
Katz, N. (2002). The impact of pain management on quality of life. Journal of Pain and Symptom Management, 24(1), S38–S47. https://doi.org/10.1016/S0885-3924(02)00411-6. CrossRefPubMed
Agency for Healthcare Research and Quality. (n.d.). Medical Expenditure Panel Survey background. Retrieved August 10, 2016, from https://meps.ahrq.gov/mepsweb/about_meps/survey_back.jsp.
Agency for Healthcare Research and Quality. (n.d.). Medical Expenditure Panel Survey home. Retrieved May 3, 2016, from http://meps.ahrq.gov/mepsweb/.
Medical Expenditure Panel Survey Public Use File Search Results. (n.d.). Retrieved January 11, 2017, from https://meps.ahrq.gov/mepsweb/data_stats/download_data_files_results.jsp?cboDataYear=All&cboDataTypeY=1%2CHousehold+Full+Year+File&buttonYearandDataType=Search&cboPufNumber=All&SearchTitle=Medical+Conditions
Multum Source Information. (n.d.). Retrieved from https://www.nlm.nih.gov/research/umls/sourcereleasedocs/current/MMSL/.
Lemke, M. (2015). Prescription opioid use in the U.S. in 2012: Characterizing sustained vs. infrequent use using the medical expenditure panel survey. Retrieved from http://www.lexjansen.com/sesug/2015/182_Final_PDF.pdf.
IMS Health. (n.d.). IMS LifeLink Health Plan Claims Database: Overview and study design issues. Retrieved November 21, 2015, from http://www.uams.edu/TRI/hsrcore/Lifelink_Health_Plan_Claims_Data_DesignIssues_wcost_April2010%5B1%5D.pdf.
U.S Department of Justice Drug Enforcement Administration Office of Diversion Control. (2014). Rules—2014—Final rule: Rescheduling of hydrocodone combination products from schedule III to schedule II. Retrieved August 11, 2016, from http://www.deadiversion.usdoj.gov/fed_regs/rules/2014/fr0822.htm.
Ware, J. (2005). How to score version 2 of the SF-12 health survey (with a supplement documenting version 1). Lincoln, RI: QualityMetric Inc.
Weblet Importer. (n.d.). Retrieved November 15, 2017, from http://gim.med.ucla.edu/FacultyPages/Hays/utils/sf12v2-1.sas.
Díaz-Arribas, M. J., Fernández-Serrano, M., Royuela, A., Kovacs, F. M., Gallego-Izquierdo, T., Ramos-Sánchez, M., et al. (2017). Minimal clinically important difference in quality of life for patients with low back pain. SPINE. https://doi.org/10.1097/BRS.0000000000002298. CrossRefPubMed
Escobar, A., Quintana, J. M., Bilbao, A., Aróstegui, I., Lafuente, I., & Vidaurreta, I. (2007). Responsiveness and clinically important differences for the WOMAC and SF-36 after total knee replacement. Osteoarthritis and Cartilage, 15(3), 273–280. https://doi.org/10.1016/j.joca.2006.09.001. CrossRefPubMed
Cohen, J. (1977). Statistical power analysis for the behavioral sciences. New York: Academic Press.
SF-12v2 TM Health Survey. (n.d.). Retrieved from http://www.cscc.unc.edu/codi/forms/UNLICOMMSFHSF12ShortFormHealthSurvey03192010.pdf.
Deyo, R. A., Cherkin, D. C., & Ciol, M. A. (1992). Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. Journal of Clinical Epidemiology, 45(6), 613–619. CrossRef
Austin, P. C. (2011). An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behavioral Research, 46(3), 399–424. https://doi.org/10.1080/00273171.2011.568786. CrossRefPubMedPubMedCentral
LaValley, M. P. (2008). Logistic regression. Circulation, 117(18), 2395–2399. https://doi.org/10.1161/CIRCULATIONAHA.106.682658. CrossRefPubMed
Krebs, E. E., Gravely, A., Nugent, S., Jensen, A. C., DeRonne, B., Goldsmith, E. S., et al. (2018). Effect of opioid vs nonopioid medications on pain-related function in patients with chronic back pain or hip or knee osteoarthritis pain. JAMA, 319(9), 872. https://doi.org/10.1001/jama.2018.0899. CrossRefPubMedPubMedCentral
Sites, B. D., Beach, M. L., & Davis, M. A. (2014). Increases in the use of prescription opioid analgesics and the lack of improvement in disability metrics among users. Regional Anesthesia and Pain Medicine, 39(1), 6–12. https://doi.org/10.1097/AAP.0000000000000022. CrossRefPubMedPubMedCentral
Warkentin, L. M., Majumdar, S. R., Johnson, J. A., Agborsangaya, C. B., Rueda-Clausen, C. F., Sharma, A. M., et al. (2014). Weight loss required by the severely obese to achieve clinically important differences in health-related quality of life: Two-year prospective cohort study. BMC Medicine, 12, 175. https://doi.org/10.1186/s12916-014-0175-5. CrossRefPubMedPubMedCentral
Parker, S. L., Adogwa, O., Mendenhall, S. K., Shau, D. N., Anderson, W. N., Cheng, J. S., et al. (2012). Determination of minimum clinically important difference (MCID) in pain, disability, and quality of life after revision fusion for symptomatic pseudoarthrosis. The Spine Journal, 12(12), 1122–1128. https://doi.org/10.1016/j.spinee.2012.10.006. CrossRefPubMed
Parker, S. L., Mendenhall, S. K., Shau, D., Adogwa, O., Cheng, J. S., Anderson, W. N., et al. (2012). Determination of minimum clinically important difference in pain, disability, and quality of life after extension of fusion for adjacent-segment disease. Journal of Neurosurgery: Spine, 16(1), 61–67. https://doi.org/10.3171/2011.8.SPINE1194. CrossRefPubMed
Ashworth, J., Green, D. J., Dunn, K. M., & Jordan, K. P. (2013). Opioid use among low back pain patients in primary care: Is opioid prescription associated with disability at 6-month follow-up? Pain, 154(7), 1038–1044. https://doi.org/10.1016/j.pain.2013.03.011. CrossRefPubMedPubMedCentral
Dobscha, S. K., Lovejoy, T. I., Morasco, B. J., Kovas, A. E., Peters, D. M., Hart, K., et al. (2016). Predictors of improvements in pain intensity in a national cohort of older veterans with chronic pain. The Journal of Pain, 17(7), 824–835. https://doi.org/10.1016/j.jpain.2016.03.006. CrossRefPubMedPubMedCentral
Benyamin, R., Trescot, A. M., Datta, S., Buenaventura, R., Adlaka, R., Sehgal, N., et al. (2008). Opioid complications and side effects. Pain Physician, 11(2 Suppl), S105–S120. PubMed
Bartoli, A., Michna, E., He, E., & Wen, W. (2015). Pain intensity and interference with functioning and well-being in subgroups of patients with chronic pain treated with once-daily hydrocodone tablets. Journal of Opioid Management, 11(6), 519–533. https://doi.org/10.5055/jom.2015.0305. CrossRef
- Evaluation of opioid use among patients with back disorders and arthritis
Corey J. Hayes
- Springer International Publishing