Prevalence of long-term opioid therapy in spine center outpatients the spinal pain opioid cohort (SPOC)

2021 ◽  
Author(s):  
Claus Manniche ◽  
Lonny Stokholm ◽  
Sophie L. Ravn ◽  
Tonny A. Andersen ◽  
Lars Brandt ◽  
...  
Keyword(s):  
Spinal Pain ◽  
Opioid Therapy

scholarly journals Long-Term Opioid Therapy in Spine Center Outpatients: Protocol for the Spinal Pain Opioid Cohort (SPOC) Study (Preprint)

2020 ◽  
Author(s):  
Claus Manniche ◽  
Lonny Stokholm ◽  
Sophie L Ravn ◽  
Tonny E Andersen ◽  
Lars PA Brandt ◽  
...  
Keyword(s):  
Spinal Pain ◽  
Opioid Therapy ◽  
Opioid Addiction ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Clinical Registry ◽  
Pain Episode ◽  
Wide Range

BACKGROUND Spinal pain is the leading cause of patient-years lived with chronic pain and disability worldwide. Although opioids are well documented as an effective short-term pain-relieving medication, more than a few weeks of treatment may result in a diminishing clinical effect as well as the development of addictive behavior. Despite recognition of opioid addiction in pain patients as a major problem commonly experienced in the clinic, no reference material exists on the scope of long-term problems in novel opioid users and the link to clinical outcomes. OBJECTIVE The main aims of this study are to describe baseline and follow-up characteristics of the Spinal Pain Opioid Cohort (SPOC), to evaluate the general use of opioids in spinal pain when an acute pain episode occurs, and to demonstrate the prevalence of long-term opioid therapy (LTOT). METHODS Prospective clinical registry data were collected from an outpatient spine center setting during 2012-2013 including patients with a new spinal pain episode lasting for more than 2 months, aged between 18 and 65 years who had their first outpatient visit in the center. Variables include demographics, clinical data collected in SpineData, the Danish National Patient Register, and The Danish National Prescription Registry. The primary outcome parameter is long-term prescription opioid use registered from 4 years before the first spine center visit to 5 years after. RESULTS This is an ongoing survey. It is estimated that more than 8000 patients fulfill the SPOC inclusion criteria. In 2019, we began the intellectual process of identifying the most relevant supplementary data available from the wide range of existing national registries available in Denmark. We have now begun merging SpineData with relevant opioid data from Danish national registers and will continue to extract data up to 2021-2022. We will also be looking at data regarding somatic or psychiatric hospitalization patterns, patient usage of health care resources, as well as their working status and disability pensions. CONCLUSIONS To our knowledge, this survey will be the first to document the scope of long-term problems regarding LTOT and opioid addiction following new spinal pain episodes and comparing descriptive follow-up data between substance users and nonusers. CLINICALTRIAL ISRCTN Registry ISRCTN69685117; http://www.isrctn.com/ISRCTN69685117 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/21380

scholarly journals Long-Term Opioid Therapy in Spine Center Outpatients: Protocol for the Spinal Pain Opioid Cohort (SPOC) Study

10.2196/21380 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e21380
Author(s):  
Claus Manniche ◽  
Lonny Stokholm ◽  
Sophie L Ravn ◽  
Tonny E Andersen ◽  
Lars PA Brandt ◽  
...  
Keyword(s):  
Spinal Pain ◽  
Opioid Therapy ◽  
Opioid Addiction ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Clinical Registry ◽  
Pain Episode ◽  
Wide Range

Background Spinal pain is the leading cause of patient-years lived with chronic pain and disability worldwide. Although opioids are well documented as an effective short-term pain-relieving medication, more than a few weeks of treatment may result in a diminishing clinical effect as well as the development of addictive behavior. Despite recognition of opioid addiction in pain patients as a major problem commonly experienced in the clinic, no reference material exists on the scope of long-term problems in novel opioid users and the link to clinical outcomes. Objective The main aims of this study are to describe baseline and follow-up characteristics of the Spinal Pain Opioid Cohort (SPOC), to evaluate the general use of opioids in spinal pain when an acute pain episode occurs, and to demonstrate the prevalence of long-term opioid therapy (LTOT). Methods Prospective clinical registry data were collected from an outpatient spine center setting during 2012-2013 including patients with a new spinal pain episode lasting for more than 2 months, aged between 18 and 65 years who had their first outpatient visit in the center. Variables include demographics, clinical data collected in SpineData, the Danish National Patient Register, and The Danish National Prescription Registry. The primary outcome parameter is long-term prescription opioid use registered from 4 years before the first spine center visit to 5 years after. Results This is an ongoing survey. It is estimated that more than 8000 patients fulfill the SPOC inclusion criteria. In 2019, we began the intellectual process of identifying the most relevant supplementary data available from the wide range of existing national registries available in Denmark. We have now begun merging SpineData with relevant opioid data from Danish national registers and will continue to extract data up to 2021-2022. We will also be looking at data regarding somatic or psychiatric hospitalization patterns, patient usage of health care resources, as well as their working status and disability pensions. Conclusions To our knowledge, this survey will be the first to document the scope of long-term problems regarding LTOT and opioid addiction following new spinal pain episodes and comparing descriptive follow-up data between substance users and nonusers. Trial Registration ISRCTN Registry ISRCTN69685117; http://www.isrctn.com/ISRCTN69685117 International Registered Report Identifier (IRRID) DERR1-10.2196/21380

scholarly journals Racial disparities in discontinuation of long-term opioid therapy following illicit drug use among black and white patients

2018 ◽  
Vol 192 ◽  
pp. 371-376 ◽  
Author(s):  
Julie R. Gaither ◽  
Kirsha Gordon ◽  
Stephen Crystal ◽  
E. Jennifer Edelman ◽  
Robert D. Kerns ◽  
...  
Keyword(s):  
Drug Use ◽  
Racial Disparities ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Opioid Therapy ◽  
Black And White ◽  
White Patients

scholarly journals Variations in Long‐Term Opioid Therapy Definitions: A Systematic Review of Observational Studies Using Routinely Collected Data (2000–2019)

2021 ◽  
Author(s):  
Juliana Oliveira Costa ◽  
Claudia Bruno ◽  
Navya Baranwal ◽  
Natasa Gisev ◽  
Timothy Dobbins ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Opioid Therapy ◽  
Routinely Collected Data

Clinician Identification of Appropriate Long-term Opioid Therapy Candidacy—Reply

2012 ◽  
Vol 172 (14) ◽  
pp. 1110 ◽  
Author(s):  
Mark Sullivan ◽  
Jane Ballantyne
Keyword(s):  
Opioid Therapy

scholarly journals Management of problematic behaviours among individuals on long-term opioid therapy: protocol for a Delphi study

BMJ Open ◽  
2016 ◽  
Vol 6 (5) ◽  
pp. e011619 ◽  
Author(s):  
Jessica S Merlin ◽  
Sarah R Young ◽  
Soraya Azari ◽  
William C Becker ◽  
Jane M Liebschutz ◽  
...  
Keyword(s):  
Delphi Study ◽  
Opioid Therapy ◽  
Therapy Protocol

142. Impact of preoperative chronic opioid therapy on long-term outcomes, reoperations, complications and resource utilization after lumbar arthrodesis

2019 ◽  
Vol 19 (9) ◽  
pp. S68-S69
Author(s):  
Joshua M. Eisenberg ◽  
Piyush Kalakoti ◽  
Nathan R. Hendrickson ◽  
Comron Saifi ◽  
Andrew J. Pugely
Keyword(s):  
Resource Utilization ◽  
Opioid Therapy ◽  
Chronic Opioid Therapy ◽  
Long Term Outcomes ◽  
Lumbar Arthrodesis

scholarly journals Managing Chronic Pain in Cancer Survivors Prescribed Long-Term Opioid Therapy: A National Survey of Ambulatory Palliative Care Providers

2019 ◽  
Vol 57 (1) ◽  
pp. 20-27 ◽  
Author(s):  
Jessica S. Merlin ◽  
Kanan Patel ◽  
Nicole Thompson ◽  
Jennifer Kapo ◽  
Frank Keefe ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Palliative Care ◽  
Cancer Survivors ◽  
National Survey ◽  
Opioid Therapy ◽  
Care Providers

scholarly journals Common Adverse Effects and Complications of Long-Term Opioid Therapy

Pain Medicine ◽  
2015 ◽  
Vol 16 (suppl 1) ◽  
pp. S1-S2 ◽  
Author(s):  
Perry Fine ◽  
Martin D. Cheatle
Keyword(s):  
Adverse Effects ◽  
Opioid Therapy

scholarly journals A Systematic Review of Randomized Trials of Long-Term Opioid Management for Chronic Non-Cancer Pain

2011 ◽  
Vol 3;14 (2;3) ◽  
pp. 91-121
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Systematic Review ◽  
Cancer Pain ◽  
Systematic Reviews ◽  
Randomized Trials ◽  
Opioid Therapy ◽  
Functional Improvement ◽  
Controlled Trials ◽  
Chronic Opioid Therapy ◽  
Level Of Evidence

Background: Even though opioids have been used for pain for thousands of years, opioid therapy for chronic non-cancer pain is controversial due to concerns regarding the long-term effectiveness and safety, particularly the risk of tolerance, dependance, or abuse. While the debate continues, the use of chronic opioid therapy for chronic non-cancer pain has increased exponentially. Even though evidence is limited, multiple expert panels have concluded that chronic opioid therapy can be effective therapy for carefully selected and monitored patients with chronic non-cancer pain. Study Design: A systematic review of randomized trials of opioid management for chronic noncancer pain. Objective: The objective of this systematic review is to evaluate the clinical efficacy of opioids in the treatment of chronic non-cancer pain. Methods: A comprehensive evaluation of the literature relating to opioids in chronic non-cancer pain was performed. The literature was evaluated according to Cochrane review criteria for randomized controlled trials (RCTs) and Jadad criteria. A literature search was conducted by using PubMed, EMBASE, Cochrane library, ECRI Institute Library, U.S. Food and Drug Administration (FDA) website, U.S. National Guideline Clearinghouse (NGC), Database of Abstracts of Reviews of Effectiveness (DARE), clinical trials, systematic reviews and cross references from systematic reviews. The level of evidence was classified as good, fair, or poor based on the quality of evidence developed by the United States Preventive Services Task Force (USPSTF) and used by other systematic reviews and guidelines. Outcome Measures: Pain relief was the primary outcome measure. Other outcome measures were functional improvement, withdrawals, and adverse effects. Results: Based on the USPSTF criteria, the indicated level of evidence was fair for Tramadol in managing osteoarthritis. For all the drugs assessed, including Tramadol, for all other conditions, the evidence was poor based on either weak positive evidence, indeterminate evidence, or negative evidence. Limitations: A paucity of literature, specifically with follow-up beyond 12 weeks for all types of opioids with controlled trials for various chronic non-cancer pain conditions. Conclusions: This systematic review illustrated fair evidence for Tramadol in managing osteoarthritis with poor evidence for all other drugs and conditions. Thus, recommendations must be based on non-randomized studies. Key words: Chronic non-cancer pain, opioids, opioid efficacy, opioid effectiveness, significant pain relief, functional improvement, adverse effects, morphine, hydrocodone, hydromorphone, fentanyl, tramadol, buprenorphine, methadone, tapentadol, oxycodone, oxymorphone, systematic reviews, randomized trials

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