Reducing the use of opioids by patients with chronic pain: an effectiveness study with long-term follow-up

This study addresses the problem of long-term opioid use by chronic pain patients. The study involved a secondary analysis of unanalyzed data from a published study of 2 versions of cognitive-behavioural therapy-based interdisciplinary treatment for chronic pain. In this study, we examined whether the use of opioids by 140 chronic pain patients could be ceased sustainably over 12 months after participation in the comprehensive interdisciplinary pain management program aimed at enhancing pain self-management. On admission to the treatment, there were no significant differences between those patients taking or not taking opioids on usual pain, pain interference in daily activities, pain-related disability, depression severity, as well as in pain cognitions. After the treatment, the use of opioids was significantly reduced, both in numbers taking any and in mean doses, and these gains were maintained over the 12-month follow-up. Finally, cessation of opioids during treatment was associated with more substantial and consistent improvements in usual pain, depression severity, pain interference, pain-related disability, and pain cognitions, relative to those who reduced their opioids but did not cease them. These findings support the idea of using training in pain self-management strategies as a viable alternative to long-term opioid use by patients with chronic pain.
Source: Pain - Category: Anesthesiology Tags: Clinical Note Source Type: research

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This study contributes a vivid illustration of older adults' CLBP illness experiences that are substantially underpinned by helplessness, depression, and a drive to continue thriving in old age. Practice implications include the need for clinic-based mood and suicide assessment. PMID: 33033826 [PubMed - as supplied by publisher]
Source: The Gerontologist - Category: Geriatrics Authors: Tags: Gerontologist Source Type: research
CONCLUSIONS: RLBP patients are more disabled than HC, but have a tendency towards a general positive psychological state of mind. Non-continuous CLBP patients would most likely present a negative psychological mindset, become more disabled and have prolonged fatigue complaints. Finally, the continuous CLBP patients are characterized by more negative attitudes and believes on pain, enhanced disability and interference of pain in their daily lives. PMID: 33016899 [PubMed - as supplied by publisher]
Source: Journal of Back and Musculoskeletal Rehabilitation - Category: Orthopaedics Tags: J Back Musculoskelet Rehabil Source Type: research
This study was conducted on 92 patients suffering from chronic LBP admitted to the rehabilitation ward. The Polish version of the 36-item WHODAS 2.0, the Sf-36 Health Survey (SF-36), the Oswestry Disability Index (ODI), the Hospital Anxiety and Depression Scale (HADS) and the Visual Analogue Scale (VAS) questionnaires were applied to assess patients. The scale score reliability of the entire tool for the study population was very high. The Cronbach’s alpha test result for the entire scale was 0.92. For the overall result of the WHODAS 2.0, the Intraclass Correlation Coefficient (ICC1,2) was 0.928, which confirmed...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
CONCLUSION: The way coping was used, and the way it was related to pain, mood, health and functioning outcomes, varied substantially across individuals. Implications for coping skills interventions are discussed. PMID: 33016774 [PubMed - as supplied by publisher]
Source: Aging and Mental Health - Category: Geriatrics Authors: Tags: Aging Ment Health Source Type: research
CONCLUSION: These results identify clinical features of veterans and service members with mTBI(s) who are at highest risk for pain-related disability. These findings also demonstrate the need to consider mental health and sleep problems in their pain evaluation and treatment approach. PMID: 33007066 [PubMed - as supplied by publisher]
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
This study aimed to evaluate fatigue and its relationship with disease parameters, functional disability, anxiety, depression, quality of life, and correlation with disease activity as determined by various scales. A total of 1028 patients (677 females, 351 males) with PsA who met the CASPAR criteria were included [Turkish League Against Rheumatism (TLAR) Network multicenter study]. The demographic features and clinical conditions of the patients were recorded. Correlations between fatigue score and clinical parameters were evaluated using the Disease Activity Score 28 (DAS28), Disease Activity in Psoriatic Arthritis (DAPS...
Source: Rheumatology International - Category: Rheumatology Source Type: research
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
CONCLUSIONS: Our results show striking variation in multimorbid conditions by gender, deprivation and ethnicity, and highlight the importance of multimorbidity, in particular comorbid depression, as a leading cause of disability among working-age adults. PMID: 32895068 [PubMed - as supplied by publisher]
Source: Psychological Medicine - Category: Psychiatry Authors: Tags: Psychol Med Source Type: research
Conclusions: MBSR classes were found to benefit participants with chronic pain and depression in this setting, fostering significant improvement in participant perceptions of pain, mood, and functional capacity. PMID: 32854117 [PubMed - in process]
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
This study derived a two‐item CP AQ for use in busy clinical settings and for repeated measurement during treatment, the CPAQ‐2. An Item Response Theory approach was used to identify the strongest items from the CPAQ‐20, one from each of its two subscales. Next, regression analyses were conducted to evaluate the utility of the CPAQ‐2 by examining variance accounted for in the CPAQ‐8, CPAQ‐20, and in measures of depression, pain‐related fear, physical disability, and psychosocial disability. Four clinical databases were combined (N = 1776) for the analyses. Items 9 and 14 were identified as the strongest CPAQ ...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
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