Opioid characteristics and nonopioid interventions associated with successful opioid taper in patients with chronic noncancer pain.
Pain
; 165(6): 1327-1335, 2024 Jun 01.
Article
en En
| MEDLINE
| ID: mdl-38112755
ABSTRACT
ABSTRACT Current research indicates that tapering opioids may improve pain and function in patients with chronic noncancer pain. However, gaps in the literature remain regarding the choice of opioid and nonopioid interventions to support a successful taper. This study used an Australian primary care data set to identify a cohort of patients on long-term opioid therapy commencing opioid taper between January 2016 and September 2019. Using logistic regression analysis, we compared key clinical factors associated with differing taper outcomes. Of a total of 3371 patients who commenced taper, 1068 (31.7%) completed taper within 12 months. In the 3 months after commencement of taper, compared with those who did not complete taper, patients who successfully completed opioid taper were less likely to be prescribed buprenorphine (odds ratio [OR] 0.691; 95% CI 0.530-0.901), fentanyl (OR, 0.429; 95% CI 0.295-0.622), and long-acting (LA) opioids, including methadone (OR, 0.349; 95% CI 0.157-0.774), oxycodone-naloxone (OR, 0.521; 95% CI 0.407-0.669), and LA tapentadol (OR, 0.645; 95% CI 0.461-0.902), but more likely to be prescribed codeine (OR, 1.308; 95% CI 1.036-1.652). Compared with those who did not complete taper, patients who successfully tapered were less likely to be prescribed any formulations of oxycodone (short-acting [SA] OR, 0.533; 95% CI 0.422-0.672, LA OR, 0.356; 95% CI 0.240-0.530) and tramadol (SA OR, 0.370; 95% CI 0.218-0.628, LA OR, 0.317; 95% CI 0.234-0.428). The type of opioid prescribed in the months after commencement of taper seems to influence the taper outcomes. These findings may inform prospective studies on opioid taper.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dolor Crónico
/
Analgésicos Opioides
Límite:
Adult
/
Aged
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Female
/
Humans
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Male
/
Middle aged
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Pain
Año:
2024
Tipo del documento:
Article
País de afiliación:
Australia