Health-related quality of life in patients receiving long-term opioid therapy: a systematic review with meta-analysis
- 02-03-2017
- Review
- Auteurs
- J. Douglas Thornton
- Rashmi Goyat
- Nilanjana Dwibedi
- George A. Kelley
- Gepubliceerd in
- Quality of Life Research | Uitgave 8/2017
Abstract
Purpose
Over 25 million Americans reported having daily pain and between 5 and 8 million Americans used opioids to treat chronic pain in 2012. This is the first systematic review with meta-analysis to determine the effects of long-term opioid use on the Physical Component Summary (PCS) score and Mental Component Summary (MCS) scores of a Health-Related Quality of Life instrument in adults without opioid use disorder.
Methods
The a priori eligibility criteria for the PubMed (MEDLINE), Scopus, and PsyINFO searches were (1) randomized controlled trial, (2) at least one opioid intervention group, (3) minimum of 4-week duration of opioid use, (4) comparative control group, and (5) adults ≥18 years that do not have dominant disease. The unit of analysis was the standardized mean difference effect size (Hedges’s g). All results were pooled using random-effects models.
Results
Of the 340 non-duplicate citations screened, 19 articles comprising 26 treatment comparisons and 6168 individuals (treatment n = 3160; comparators n = 3008 with duplicates removed) met the inclusion criteria for the systematic review. Thirteen treatment comparisons were available for the meta-analysis. Across all PCS analyses, small, statistically significant improvements were observed (opioid versus opioid only: g = 0.27, 95% CI 0.05–0.50, opioid versus placebo only: g = 0.18, 95% CI 0.08–0.28, and all studies combined: g = 0.22, 95% CI 0.11–0.32). There were small but not statistically significant changes on the MCS scores. Overall, high heterogeneity was present.
Conclusions
PCS scores improve with no change in MCS scores. However, long-term opioid trials are rare and only two trials included lasted longer than 1 year.
- Titel
- Health-related quality of life in patients receiving long-term opioid therapy: a systematic review with meta-analysis
- Auteurs
-
J. Douglas Thornton
Rashmi Goyat
Nilanjana Dwibedi
George A. Kelley
- Publicatiedatum
- 02-03-2017
- Uitgeverij
- Springer International Publishing
- Gepubliceerd in
-
Quality of Life Research / Uitgave 8/2017
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649 - DOI
- https://doi.org/10.1007/s11136-017-1538-0
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