Opioid Reduction Strategies Could Improve Pain, Quality of Life

Opioid reduction therapy in patients with chronic pain was associated with benefits to pain, function, and quality of life, according to data from a recent study.

Guidelines currently recommend reducing of discontinuing long-term opioid therapy (LTOT) when risks outweigh benefits, but the effect of dose reduction on patient outcomes has not been reviewed.
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For their study, researchers examined data from 67 studies, (11 randomized trials and 56 observational studies) examining 8 intervention categories, including interdisciplinary pain programs, buprenorphine-assisted dose reduction, and behavioral interventions.

Overall, many of the studies reported dose reduction, but rates of opioid discontinuation ranged widely. Among the 40 studies detailing patient outcomes following dose reduction, improvement in pain severity, function, and quality of life were reported. However, the overall quality of evidence was deemed very low.

“Very low quality evidence suggests that several types of interventions may be effective to reduce or discontinue LTOT and that pain, function, and quality of life may improve with opioid dose reduction,” the researchers concluded.

—Michael Potts

Reference:

Frank JW, Lovejoy TI, Becker WC, et al. Patient outcomes in dose reduction or discontinuation of long-term opioid therapy: a systematic review [published online July 18, 2017]. Ann Intern Med. DOI: 10.7326/M17-0598