Adherence and long-term effect of oxycodone/paracetamol in chronic noncancer pain: a retrospective study

Gatti, Antonio; Mammucari, Massimo; Sabato, Elisabetta; Masucci, Loredana; Sabato, Alessandro

doi:10.1007/s12325-011-0020-6

Cited by 7 publications

(5 citation statements)

References 29 publications

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“…Recent meta-analyses of randomized controlled trials (RCTs) on opioids versus placebo described maximum mean pain reductions of 14 units on a 100-point scale and standardized mean differences (SMDs) between 0.19 and 0.70 (Furlan et al, 2006;Martell et al, 2007;Papaleontiou et al, 2010;Chaparro et al, 2013;McNicol et al, 2013). Larger effects were only reported in uncontrolled observational studies (Noble et al, 2010;Gatti et al, 2011). However, most RCTs merely used effect sizes at the end of treatment (post-post comparisons).…”

Section: Introductionmentioning

confidence: 99%

Analgesic efficacy of opioids in chronic pain: recent meta‐analyses

Reinecke

Weber

Lange

et al. 2014

British J Pharmacology

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Opioids are regularly administered in acute and cancer pain. In chronic non-cancer pain (CNCP), however, their use is controversial. Previous meta-analyses and randomized controlled trials (RCTs) lack methodological homogeneity and comparable data. Here we analysed the maximum analgesic efficacies of opioids and non-opioids compared with placebo, and of physiotherapy and psychotherapy compared with active or waiting-list controls. We screened 3647 citations and included RCTs if treatment duration was at least 3 weeks, data were sufficient for meta-analysis, and criteria for high quality were met. Only 46 studies (10 742 patients) met the criteria. Weighted and standardized mean differences (WMD, SMD) between pain intensities were pooled to conduct separate meta-analyses for each treatment category. At the end of treatment the WMD for pain reduction (100-point scale) was 12.0 for 'strong' opioids, 10.6 for 'weak' opioids, 8.4 for non-opioids (each vs. placebo), 5.5 for psychotherapy and 4.5 for physiotherapy (each vs. active controls). Dropout rates were high in pharmacological studies. The 95% confidence intervals using the outcomes of control groups did not indicate statistical differences between efficacies of the five interventions. Because not enough eligible head-to-head trials were available, our analysis is limited to adjusted indirect comparisons. The heterogeneity of pre-post pain differences in control groups did not allow the definition of a common comparator. In conclusion, although there were statistically significant differences between maximum treatment efficacies, no intervention per se produced clinically important improvements in average pain intensity. Thus, opioids alone are inappropriate and multimodal treatment programmes may be required for CNCP. LINKED ARTICLESThis article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx

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Section: Introductionmentioning

confidence: 99%

Analgesic efficacy of opioids in chronic pain: recent meta‐analyses

Reinecke

Weber

Lange

et al. 2014

British J Pharmacology

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“…In fact, patients with chronic pain commonly modify their prescribed medication regimens [21,22]. Due to the variable nature of pain, patients may adjust their regimen based on the frequency or intensity of pain [23–47]. Published evidence has shown that adherence to opioid analgesics may be medication dependent, as demonstrated in Table 1.…”

Section: Introductionmentioning

confidence: 99%

“…Unfortunately, patients may not provide details regarding their medication‐taking behavior or the modifications they have made [48–50]. Numerous tools exist to monitor patient adherence to therapy, including urine drug testing (UDT), prescription drug monitoring programs, and patient self‐report [18–45]. However, patient self‐report is often not reliable as a single measure of medication adherence and may provide information discordant with the prescribed regimen.…”

Section: Introductionmentioning

confidence: 99%

“…found a significant number of drug tests were susceptible to interpretation errors [71]. With adequate understanding and interpretation of the results, prescribers can use UDT to monitor use of prescribed medications, identify the use of nonprescribed medications, or use of illicit substances [21,23–46,72,73]. In general, a UDT result that is expectedly positive for a prescribed medication suggests medication adherence and an unexpected result (e.g., negative for prescribed medication, or positive for nonprescribed medication or illicit substance) suggests either nonadherence to the prescribed regimen or aberrant behaviors that should be further explored by the prescriber [1,2,29,43,66,67,70,74–82].…”

Section: Introductionmentioning

confidence: 99%

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Interpretation of Urine Drug Testing in Pain Patients

et al. 2012

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Background. Traditionally, urine drug screens have only been concerned with positive or negative results. Those results provide physicians treating patients for pain with chronic opioid therapy with information about medication compliance, use of nonprescribed medications, and use of illicit drugs. However, the analysis of urine for drugs offers additional information that, when compiled and accurately interpreted, may also be of great value to these doctors. Purpose: The aim of this article was to discuss the interpretation of urine drug tests and their application to pain physician practices. Method. We utilized a selection of recent articles on urine drug screening applicable to the pain patient population. Results and Conclusions. The article provides pertinent information about interpretation of urine drug testing, which is separated into six categories: which drugs and metabolites to test for; which analytical cutoffs to use; pain medication metabolism; identification of alcohol use; determination of patient compliance; and which patient groups to consider for more frequent testing.

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“…The combination of antipyretic and analgesic drugs with oxycodone not only complements the mechanism of action and improves analgesic efficacy, but also reduces the dose of oxycodone alone and reduces adverse effects such as oxycodone tolerance and addiction. Several clinical studies have confirmed that this compound has been widely used for clinical analgesia, including rheumatoid arthritis, osteoarthritis pain in elderly women, chronic non-cancer pain, cancer pain, post-surgical pain, chronic skeletal muscle sarcoid pain and neuropathic pain of various moderate to severe pain, all of which have shown good analgesic effects[ 22 , 35 , 36 ].…”

Section: Combination Medicationmentioning

confidence: 99%

Advances in the clinical application of oxycodone in the perioperative period

Chen¹,

Wang²,

Zhang³

et al. 2022

WJCC

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To review the research progress of pure opioid receptor agonist oxycodone. The research progress of oxycodone in terms of pharmacokinetics, pharmacodynamics, adverse reactions, clinical application, combined medication and new progress in clinical application was summarized by referring to the literature. Oxycodone is a semi-synthetic thebaine derivative of opioid alkaloids, and is a pure opioid μ and κ receptor agonist. The main action sites are the central nervous system and visceral smooth muscle. Due to its advantages of low adverse reactions, good analgesic effects, and a wide range of safe doses, the drug has been widely used in the control of acute and chronic postoperative pain, as well as malignant and non-malignant pain. Since the end of the 20 th century, researchers have begun to formulate antipyretic analgesics, opioid receptor agonists, opioid receptor antagonists, dopamine receptor antagonists and other drugs with oxycodone in different proportions to enhance the analgesic effect. At the same time, it can reduce the dosage of oxycodone and reduce its adverse reactions, so as to achieve the purpose of limiting opioid abuse. With the continuous research on the efficacy and safety of oxycodone in the perioperative period at home and abroad, oxycodone has become the only dual-opioid potent analgesic that can be used in clinical work.

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Adherence and long-term effect of oxycodone/paracetamol in chronic noncancer pain: a retrospective study

Cited by 7 publications

References 29 publications

Analgesic efficacy of opioids in chronic pain: recent meta‐analyses

Analgesic efficacy of opioids in chronic pain: recent meta‐analyses

Interpretation of Urine Drug Testing in Pain Patients

Advances in the clinical application of oxycodone in the perioperative period

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