Funding sources: This study was funded by grants from Canadian Foundation for Innovation (#7878) and Pfizer.
NEUROPATHIC PAIN SECTION
Physical Functioning and Opioid use in Patients with Neuropathic Pain
Version of Record online: 3 FEB 2015
Wiley Periodicals, Inc
Volume 16, Issue 7, pages 1361–1368, July 2015
How to Cite
Bostick, G. P., Toth, C., Carr, E. C.J., Stitt, L. W., Morley-Forster, P., Clark, A. J., Lynch, M., Gordon, A., Nathan, H., Smyth, C., Ware, M. A. and Moulin, D. E. (2015), Physical Functioning and Opioid use in Patients with Neuropathic Pain. Pain Medicine, 16: 1361–1368. doi: 10.1111/pme.12702
Conflicts of interest: Drs. Toth and Moulin have received research funding and honoraria for continuing education seminars from Pfizer Canada. Dr. Morley-Forster has received a speaker's honorarium from Purdue (in the past 2 years). The remaining authors declare no conflicts.
- Issue online: 15 JUL 2015
- Version of Record online: 3 FEB 2015
- Neuropathic Pain;
- Opioid Therapy;
- Physical Functioning
To evaluate the association between opioid dosage and ongoing therapy with physical function and disability in patients with neuropathic pain (NeP).
Secondary analysis of a prospective cohort.
Multicenter clinical NeP registry.
Seven hundred eighty-nine patients treated for various NeP diagnoses.
The following measures were included: dependent variables. 12-month self-reported physical function (pain disability index [PDI] and medical outcomes study short form-12 physical function [PCSS-12]); independent variables: baseline opioid dose (none, ≤200 mg and >200 mg of morphine equivalent), ongoing opioid use; potential confounding variables: age, sex, baseline pain intensity, and psychological distress (profile of mood states). Analysis of covariance models was created to examine the relationship between opioid therapy and both physical functioning outcomes with adjustment for confounding.
Complete data was available for 535 patients (68%). Compared with the lower and high dose opioid groups, NeP patients not taking opioids had statistically lower disability and higher physical functioning scores, after adjusting for disease severity. Compared with patients prescribed opioid therapy on an ongoing basis, NeP patients who were not prescribed had statistically lower disability and higher physical functioning scores, after adjusting for disease severity. Improvements in disability and physical functioning scores from baseline and 12-months in all groups were modest and may not be clinically significant.
Physical functioning and disability did not improve in patients with NeP who were prescribed opioids compared with those who are not prescribed, even after adjusting for disease severity.