AI Article Synopsis
- The CDC's 2016 guideline on opioid prescribing aimed at primary care physicians led to a survey assessing the effects of opioid dose reductions on chronic pain patients.
- A total of 362 respondents were analyzed, revealing that those whose extended-release/long-acting (ER/LA) opioid doses were decreased reported significantly worse outcomes in pain, function, mental health, employment, and relationships compared to those whose doses remained unchanged.
- The findings indicate that reducing opioid doses in chronic pain patients may lead to decreased pain management and functional abilities, highlighting a need for clearer guidance on implementing opioid prescribing guidelines.
Article Abstract
Background: In 2016, the Centers for Disease Control and Prevention (CDC) released a guideline on opioid prescribing for primary care physicians. Patients with chronic pain receiving long-term opioid therapy were surveyed to assess the incidence and impact of opioid dose reduction following this guideline's promulgation.
Methods: Members of an advocacy organization for people with chronic pain were invited to participate in a 16-item, anonymous, online survey conducted in September/October 2017. Eligibility requirements included current treatment of ≥7 months' duration for chronic pain with the same extended-release (ER)/long-acting (LA) opioid. The final sample consisted of respondents who reported being on the same ER/LA opioid for ≥1 year and excluded respondents whose 1) ER/LA opioid dose increased; 2) ER/LA opioid dose decreased and immediate-release (IR) opioid dose increased; and 3) ER/LA opioid dose was unchanged and IR opioid dose was changed. Survey results were analyzed using -test to ascertain differences between proportion of responses for ER/LA opioid dose decreased vs dose unchanged groups.
Results: Of the 511 eligible respondents, 362 respondents were included in the final sample. In the final sample, the subgroup with decreased ER/LA opioid dose (n=149) was significantly more likely (≤ 0.05) than those who reported no dose change (n=213) to rate their condition as "worse" for level of pain (73.2 vs 33.3%), level of function (67.8 vs 31.5%), mental health (64.4 vs 32.9%), ability to work (62.9% of 97 respondents vs 33.8% of 145 respondents), and interpersonal relationships (48.3 vs 25.8%) during the previous 6 months.
Conclusion: In this Internet-based survey of people with chronic pain, reduction of ER/LA opioid dose was associated with reduced pain control and diminished function. These results indicate a need for further guidance on how to apply the CDC guideline to patients with chronic pain who are stable on long-term opioid therapy.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235338 | PMC |
| http://dx.doi.org/10.2147/JPR.S175402 | DOI Listing |
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