Opioids unlikely to be helpful for long-term management of chronic noncancer pain
The use of opioids may have limited long-term efficacy in the management of chronic noncancer pain (CNCP), reports a new study.
Researchers conducted a 2-year prospective cohort study including 529 CNCP patients (71.6 percent female). Propensity score matching was performed to control for characteristic differences between those with and without opioid use. The Brief Pain Inventory and short version of the Treatment Outcomes in Pain Survey were used to assess pain outcomes and quality of life.
At baseline, the prevalence of opioid prescription was 59.7 percent. Of the 316 prescriptions, 86 (16.2 percent) were for strong opioids. The overall rate rose to 60.3 percent (n=319) and 72.6 percent (n=384) after 5 and 12 months of follow-up. While there was a slight dip in overall prescription prevalence by 24 months (70.3 percent; n=372), prescription prevalence for strong opioids grew substantially (42.7 percent; n=226).
After propensity score matching, researchers found no clear indication that long-term opioid use held significant benefits. At 12 months, in nonusers, for example, the rates of clinical improvement in pain symptoms (p=0.014), physical function of the lower body (p=0.014) and severity (p=0.001) were significantly higher than their opioid-using counterparts.
In contrast, users showed a significantly higher rate of improvement in satisfaction with outcomes (p=0.030) and with care (p=0.044).
“Opioid users presented no improvement regarding pain relief, functional outcomes and quality of life over 2 years of follow-up. Therefore, our results support and highlight the limited effectiveness of opioids in long-term CNCP management,” said researchers.