To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Researchers Rationalise Guidelines on Opioid Use for Chronic Noncancer Pain: Presented at WCP URL: http://www.pslgroup.com/dg/229DD6.htm Doctor's Guide August 25, 2008
By Sara Freeman GLASGOW, United Kingdom -- August 25, 2008 -- Twelve criteria can help rationalise the use of opioids for chronic noncancer pain, according to research presented here at the 12th World Congress on Pain (WCP). According to study presenter Elena Catala, MD, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, and associates the use of opioids for noncancer pain is increasing in the United States and in many European countries, and this has raised concern among some physicians and their patients. However, quality of life among patients with chronic noncancer pain can be reduced significantly, and many of these patients may benefit greatly from the use of strong analgesics or opioids. "Dependency and addiction do not justify not relieving pain," the researchers noted. "The use of opioids to relieve chronic pain is a legitimate medical practice." To distil out the most important criteria on the appropriate use of opioids for chronic noncancer pain, Dr. Catala and colleagues looked at practice guidelines from 14 international societies and professional bodies, including the American Society of Anesthesiologists, The American Pain Society, the American Geriatrics Society, The North American Spine Society, and the American Society of Interventional Pain Physicians. They used the Appraisal of Guidelines Research & Evaluation (AGREE) instrument to assess the quality of each clinical guideline, Dr. Catala said in an interview on August 20. Using this approach, they identified 12 criteria that should be present or considered when prescribing opioids for chronic noncancer pain. First, any clinical condition that could potentially interfere with the use of opioids should be identified, and second, doctors should check that the patient has been treated appropriately beforehand. Next, a complete evaluation of patients' pain and functionality should be made and the need for opioids confirmed. After obtaining informed consent, initial opioid treatment should aim to obtain the maximum benefit with a minimum of adverse effects. "If good effectiveness is not obtained or there are intolerable adverse effects," the opioid agent should be changed, suggested Dr. Catala and colleagues. For the maintenance phase, they suggested a suitable dose should be given that "provides a good relief and improves the functionality." Patients should be reviewed regularly, every 4 to 9 weeks, by the same medical team. Throughout treatment, drug prescription data should be logged and the value of the pain management/effectiveness should be regularly assessed. If chronic pain is not improved, or the indication for opioid use is no longer valid then treatment should be withdrawn at a rate of 20% to 50% dose reduction every week. Dr. Catala said that if these recommendations are followed, then "opioid use is not necessarily controversial," for chronic noncancer pain. [Presentation title: Opioids in Non-Oncologic Chronic Pain: Rational Use of Guides to Clinical Practice. Abstract PT223] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.