Journal article
Use of pharmacological and non-pharmacological treatments for chronic non-cancer pain among people using opioids: a longitudinal cohort study
Pain, Vol.163(6), pp.1049-1059
2022
Abstract
Although multimodal management of chronic non-cancer pain (CNCP) is recommended, long-term treatment utilization patterns among people using opioids are not well known. The Pain and Opioids IN Treatment (POINT) study recruited Australian adults receiving opioids for CNCP for more than six weeks from community pharmacies. Pharmacological (opioid and non-opioid analgesics, psychotropic medicines) and non-pharmacological (physical, mental health, specialized) treatments used in the previous 12-months and 30-days were collected annually over four years (2015-2018). Associations were explored between 30-day treatment use and sociodemographic characteristics and pain measures. Overall, 1334 participants completed at least one annual follow-up. Median pain severity (5.0, interquartile range (IQR) 3.8-6.3) and pain interference scores (5.7, IQR 3.9-7.3) indicated moderate pain throughout the study period, despite most participants reporting use of non-opioid pharmacological (12-month: 97.6%; 30-day: 96.8%) and non-pharmacological treatments (12-month: 91.8%; 30-day: 66.1%). Some treatment use was inconsistent with guidelines: ongoing non-steroidal anti-inflammatory drugs (NSAIDs) and sedative-hypnotic use were common, while fewer people engaged with pain management programs (12-month: 22.3%). Private health insurance was associated with using physical (adjusted odds ratio (aOR) 1.61, 99.5% confidence intervals (CI) 1.15-2.24) and specialized non-pharmacological treatments (aOR 1.47, 99.5%CI 1.14-1.91). This study demonstrates that many Australians taking opioids long-term for CNCP also use non-opioid pharmacological and non-pharmacological treatments. Use of pharmacological treatments including NSAIDs, psychotropic medicines, and gabapentinoids, outside guidelines warrants review. Furthermore, despite Australia's universal healthcare scheme subsidising some non-pharmacological treatments, overall use of these treatments was associated with having private health insurance, highlighting a need for more equitable service provision.
Details
- Title
- Use of pharmacological and non-pharmacological treatments for chronic non-cancer pain among people using opioids: a longitudinal cohort study
- Authors
- Ria E Hopkins (Author) - UNSW AustraliaGabrielle Campbell (Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - LegacyLouisa Degenhardt (Author) - University of TasmaniaSuzanne Nielsen (Author) - UNSW AustraliaFiona Blyth (Author) - University of SydneyMilton Cohen (Author) - St Vincent's Hospital SydneyNatasa Gisev (Author) - UNSW Australia
- Publication details
- Pain, Vol.163(6), pp.1049-1059
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/j.pain.0000000000002484
- ISSN
- 1872-6623
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Health and Behavioural Sciences - Legacy
- Language
- English
- Record Identifier
- 99578906202621
- Output Type
- Journal article
Metrics
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- Domestic collaboration
- Web Of Science research areas
- Anesthesiology
- Clinical Neurology
- Neurosciences
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