HCPLive Network

Data Support Long-Term Efficacy for Opioid Therapy for Chronic Non-Cancer Pain

 
There are several ethical, regulatory, and logistical challenges to conducting long-term placebo-controlled, double-blind randomized controlled trials (RCTs). Because of this, the majority of contemporary phase III trials on opioid efficacy and safety do not last longer than three months.
 
In light of this, open-label studies are particularly valuable, as they are often of longer duration and “reflect patient experience before and after long-term opioid therapy,” according to the authors of a poster presented at the American Pain Society’s 32nd Annual Scientific Meeting, held May 8-13, 2013, in New Orleans, LA.
 
In “Long-term Efficacy and Safety of Opioid Therapy for Chronic Non-cancer Pain: Evidence from Randomized and Open-label Studies,” Matsuno, Wallace, Glanzman, et al, analyzed data from published RCTs and open-label studies that had a duration of six months or longer to learn more about the long-term efficacy and safety of opioid therapy for patients with chronic non-cancer pain.
 
They conducted a literature search of major databases to identify RCTs, single-arm open-label trials, and open-label extension studies following an RCT that were six months or more in duration. They also searched clinical guidelines, consensus statements, and other sources to identify additional articles.


Further Reading
Understanding patients is important for all doctors, including those working with patients with limited English proficiency, according to an article published in the September/October issue of the Annals of Family Medicine.
Although methadone accounts for only 2 percent of opioid prescriptions, it caused nearly one in three prescription opioid overdose deaths in 2012, a six-fold increase from 2009, according to the CDC.
Because there is no objective test for pain, and because each patient’s experience of his or her painful condition is subjective and unique, physicians who treat these patients must process a variety of symptoms, signs, and cues to determine whether they can trust their patient’s narrative.
The challenge to medical practices is clear. Recruiting and retaining physicians during a current and looming shortage of healthcare professionals can be a daunting task.
A 6-year study of people with type 2 diabetes shows that intensively lowering blood pressure has a long-lasting effect in preventing heart attacks, strokes, and deaths, but intensive blood glucose control does not. The findings were published online Sept. 19 in the New England Journal of Medicine to coincide with presentation of the findings at the annual meeting of the European Association for the Study of Diabetes in Vienna.
Women of childbearing age in the United States should be encouraged to maintain better oral care and visit the dentist routinely, according to a study published Sept. 18 in the US Centers for Disease Control and Prevention's Preventing Chronic Disease. Researchers found young pregnant women, those who are non-Hispanic black or Mexican-American, as well as those with lower income and less education, need to improve their oral care.
Consumers are more likely to buy high-calorie foods (HCF), but not low-calorie foods (LCF) on sale, according to a study published in the US Center for Disease Control and Prevention's Preventing Chronic Disease.
More Reading
Understanding patients is important for all doctors, including those working with patients with limited English proficiency, according to an article published in the September/October issue of the Annals of Family Medicine.