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23-07-2018 | Uitgave 11/2018

Quality of Life Research 11/2018

Evaluation of opioid use among patients with back disorders and arthritis

Tijdschrift:
Quality of Life Research > Uitgave 11/2018
Auteurs:
Corey J. Hayes, Nalin Payakachat, Chenghui Li
Belangrijke opmerkingen

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s11136-018-1941-1) contains supplementary material, which is available to authorized users.

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Extra materiaal
Supplementary material 1 (DOCX 27 KB)
11136_2018_1941_MOESM1_ESM.docx
Supplementary material 2 (DOCX 17 KB)
11136_2018_1941_MOESM2_ESM.docx
Supplementary material 3 (DOCX 19 KB)
11136_2018_1941_MOESM3_ESM.docx
Supplementary material 4 (DOCX 20 KB)
11136_2018_1941_MOESM4_ESM.docx
Literatuur
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