Citation

Morasco BJ, Yarborough BJ, Smith NX, Dobscha SK, Deyo RA, Perrin NA, Green CA. J. Pain 2016; 18(4): 437-445.

Affiliation

Kaiser Permanente Northwest Center for Health Research; Public Health and Preventive Medicine, Oregon Health & Science University.

Copyright

(Copyright © 2016, Elsevier Publishing)

DOI

10.1016/j.jpain.2016.12.004

PMID

27993558

Abstract

Some prior research has examined pain-related variables based on prescription opioid dose, but data from studies involving patient-reported outcomes have been limited. This study examined the relationships between prescription opioid dose and self-reported pain intensity, function, quality of life, and mental health. Participants were recruited from two large integrated health systems, Kaiser Permanente Northwest (n=331) and VA Portland Health Care System (n=186). To be included, participants had to have musculoskeletal pain diagnoses and be receiving stable doses of long-term opioid therapy (LTOT). We divided participants into three groups based on current prescription opioid dose in daily morphine equivalent doses (MED): Low Dose (5 - 20 mg MED), Moderate Dose (20.1 - 50 mg MED), and Higher Dose (50.1 - 120 mg MED) groups. A statistically significant trend emerged where higher prescription opioid dose was associated with moderately-sized effects including greater pain intensity, more impairments in functioning and quality of life, poorer self-efficacy for managing pain, greater fear avoidance, and more healthcare utilization. Rates of potential alcohol and substance use disorders also differed among groups.

FINDINGS from this evaluation reveal significant differences in pain-related and substance-related factors based on prescription opioid dose. PERSPECTIVE: This study included 517 patients who were prescribed long-term opioid therapy and compared differences on pain and mental health-related variables based on prescription opioid dose.

FINDINGS reveal small to medium-sized differences on pain-related variables, alcohol and substance use, and healthcare utilization based on the dose of opioid prescribed.

Copyright © 2016. Published by Elsevier Inc.

Language: en