Advanced search
1 file | 3.95 MB Add to list

Impact of long-term use of opioids on quality of life in patients with chronic, non-malignant pain

Author
Organization
Abstract
Objective: The use of opioids in the management of non-malignant pain remains controversial. For many physicians, pain relief stemming from opioid use is not enough unless there is also a noticeable change in quality of life (QoL) and patient functioning. The impact of long-term opioid treatment on patients' QoL has been investigated in a limited number of trials, and these studies differ considerably with respect to their design and principal findings. This systematic review presents the results of these studies. Design and methods: MEDLINE (1966 to November/December 2004), EMBASE (1974 to November/December 2004), the Oxford Pain Relief Database (Bandolier; 1954-1994) and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for relevant papers by combining search terms for function with terms for opioid analgesia, non-malignant and pain. Studies were eligible for inclusion if they met all of the pre-defined criteria specifying study design, population, intervention and outcome measures. Results: Eleven studies evaluated long-term treatment with opioids in patients with chronic, non-malignant pain and assessed QoL (N = 2877). Six studies were randomised trials and the remaining five were observational studies. In general, the former had higher Jadad rating scores for the quality of the paper than the latter. Of the four randomised studies in which baseline OoL was reported, three showed an improvement in OoL. Similarly, of the five observational studies, a significant improvement in OoL was reported in four. Conclusions: There is both moderate/high- and low-quality evidence suggesting that long-term treatment with opioids can lead to significant improvements in functional outcomes, including OoL, in patients with chronic, non-malignant pain. However, further methodologically rigorous investigations are required to confirm the long-term QoL benefit of opioid treatment in these patients, and to elucidate the effect of physical tolerance, withdrawal and addiction, which are all associated with long-term use of opioids, on patients' functional status.
Keywords
non-malignant, chronic pain, opioid analgesics, quality of life, CHRONIC NONCANCER PAIN, TRANSDERMAL FENTANYL, RANDOMIZED-TRIAL, CLINICAL-TRIAL, ORAL MORPHINE, DOUBLE-BLIND, BACK-PAIN, THERAPY, EFFICACY, MANAGEMENT

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 3.95 MB

Citation

Please use this url to cite or link to this publication:

MLA
Devulder, Jacques, U Richarz, and SH Nataraja. “Impact of Long-term Use of Opioids on Quality of Life in Patients with Chronic, Non-malignant Pain.” CURRENT MEDICAL RESEARCH AND OPINION 21.10 (2005): 1555–1568. Print.
APA
Devulder, J., Richarz, U., & Nataraja, S. (2005). Impact of long-term use of opioids on quality of life in patients with chronic, non-malignant pain. CURRENT MEDICAL RESEARCH AND OPINION, 21(10), 1555–1568.
Chicago author-date
Devulder, Jacques, U Richarz, and SH Nataraja. 2005. “Impact of Long-term Use of Opioids on Quality of Life in Patients with Chronic, Non-malignant Pain.” Current Medical Research and Opinion 21 (10): 1555–1568.
Chicago author-date (all authors)
Devulder, Jacques, U Richarz, and SH Nataraja. 2005. “Impact of Long-term Use of Opioids on Quality of Life in Patients with Chronic, Non-malignant Pain.” Current Medical Research and Opinion 21 (10): 1555–1568.
Vancouver
1.
Devulder J, Richarz U, Nataraja S. Impact of long-term use of opioids on quality of life in patients with chronic, non-malignant pain. CURRENT MEDICAL RESEARCH AND OPINION. 2005;21(10):1555–68.
IEEE
[1]
J. Devulder, U. Richarz, and S. Nataraja, “Impact of long-term use of opioids on quality of life in patients with chronic, non-malignant pain,” CURRENT MEDICAL RESEARCH AND OPINION, vol. 21, no. 10, pp. 1555–1568, 2005.
@article{324479,
  abstract     = {Objective: The use of opioids in the management of non-malignant pain remains controversial. For many physicians, pain relief stemming from opioid use is not enough unless there is also a noticeable change in quality of life (QoL) and patient functioning. The impact of long-term opioid treatment on patients' QoL has been investigated in a limited number of trials, and these studies differ considerably with respect to their design and principal findings. This systematic review presents the results of these studies. 
Design and methods: MEDLINE (1966 to November/December 2004), EMBASE (1974 to November/December 2004), the Oxford Pain Relief Database (Bandolier; 1954-1994) and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for relevant papers by combining search terms for function with terms for opioid analgesia, non-malignant and pain. Studies were eligible for inclusion if they met all of the pre-defined criteria specifying study design, population, intervention and outcome measures. 
Results: Eleven studies evaluated long-term treatment with opioids in patients with chronic, non-malignant pain and assessed QoL (N = 2877). Six studies were randomised trials and the remaining five were observational studies. In general, the former had higher Jadad rating scores for the quality of the paper than the latter. Of the four randomised studies in which baseline OoL was reported, three showed an improvement in OoL. Similarly, of the five observational studies, a significant improvement in OoL was reported in four. 
Conclusions: There is both moderate/high- and low-quality evidence suggesting that long-term treatment with opioids can lead to significant improvements in functional outcomes, including OoL, in patients with chronic, non-malignant pain. However, further methodologically rigorous investigations are required to confirm the long-term QoL benefit of opioid treatment in these patients, and to elucidate the effect of physical tolerance, withdrawal and addiction, which are all associated with long-term use of opioids, on patients' functional status.},
  author       = {Devulder, Jacques and Richarz, U and Nataraja, SH},
  issn         = {0300-7995},
  journal      = {CURRENT MEDICAL RESEARCH AND OPINION},
  keywords     = {non-malignant,chronic pain,opioid analgesics,quality of life,CHRONIC NONCANCER PAIN,TRANSDERMAL FENTANYL,RANDOMIZED-TRIAL,CLINICAL-TRIAL,ORAL MORPHINE,DOUBLE-BLIND,BACK-PAIN,THERAPY,EFFICACY,MANAGEMENT},
  language     = {eng},
  number       = {10},
  pages        = {1555--1568},
  title        = {Impact of long-term use of opioids on quality of life in patients with chronic, non-malignant pain},
  url          = {http://dx.doi.org/10.1185/030079905X65321},
  volume       = {21},
  year         = {2005},
}

Altmetric
View in Altmetric
Web of Science
Times cited: