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When the harms of opioid therapy outweigh the benefits, overprescribing of opioids for patients with chronic noncancer pain has led to the recent enactment of guidelines
recommending reduction or discontinuation of long-term opioid therapy .
In a study published today in the top journal BMJ, researchers aimed to evaluate interventions to reduce long-term opioid therapy in patients with chronic noncancer pain, taking into account dose reduction and discontinuation, pain, function, quality of life , Efficacy of withdrawal symptoms, drug use, and adverse events
.
We conducted a systematic review and meta-analysis of randomized controlled trials and nonrandomized studies of the intervention
Quality of Life
Two investigators independently selected studies, extracted data, and used the Cochrane Risk of Bias tool (RoB2 and ROBINS-I) in randomized and non-randomized studies
.
The investigators grouped interventions into five categories (pain self- management , complementary and alternative medicine, pharmacological and biomedical devices and interventions, opioid substitution therapy, and stress reduction methods), using a random-effects meta-analysis model to estimate pooled effects, The certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluation)
manage
Of the 166 studies that met the inclusion criteria, 130 (78%) were considered to be at serious risk of bias and excluded from the synthesis of evidence
.
Of the 36 included studies, there were few controlled treatment groups and sample sizes were generally small
CONCLUSIONS : Evidence for reducing chronic pain with long-term opioid therapy remains limited by study methodology
.
Of particular concern is the lack of evidence related to possible harms
Evidence for reducing chronic pain with long-term opioid therapy remains limited by study methodology
Original source:
Nicholas Avery, et al.
Nicholas Avery, et al.
Efficacy of interventions to reduce long term opioid treatment for chronic non-cancer pain: systematic review and meta-analysis .
BMJ.
2022;https:// -066375 Efficacy of interventions to reduce long term opioid treatment for chronic non-cancer pain: systematic review and meta-analysisLeave a message here
