Correlates of Use and Perceived Effectiveness of Non-pharmacologic Strategies for Chronic Pain Among Patients Prescribed Long-term Opioid Therapy

Lozier, Crystal C; Nugent, Shannon M.; Smith, Ning; Yarborough, Bobbi Jo H.; Dobscha, Steven K.; Deyo, Richard A.; Morasco, Benjamin J.

doi:10.1007/s11606-018-4325-x

Cited by 15 publications

(21 citation statements)

References 67 publications

(76 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Non-pharmacological approaches have shown success among older adults and include: cognitivebehavioral therapies (CBT) for anxiety, insomnia, and/or pain; mindfulness; acupuncture; and physical therapy options. 14,18,19,[36][37][38] In the PCP environment, however, multisession interventions have lacked practicality because of time and resource limitations. In addition, many published interventions remain within research settings, involve small study samples, and consequently have not been widely implemented.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Use of Opioids with Other Central Nervous System-Active Medications Among Older Adults

Wang

Slindee

Ruiz

et al. 2020

Population Health Management

View full text Add to dashboard Cite

The primary objective was to determine the prevalence and characteristics of older adults concurrently using opioids and other central nervous system (CNS)-active medications, and the specialties of providers who ordered the medications. A secondary objective was to document medication-related adverse effects associated with such concurrent drug use. Study populations were identified as older adults aged ‡65 years with 1 year continuous medical and drug plan enrollment during 2017 and opioid use of ‡2 prescriptions for ‡15 days' supply. CNSactive medications included benzodiazepines, non-benzodiazepine hypnotics, muscle relaxants, antipsychotics, and gabapentinoids. Provider specialties were identified from the National Provider Identification database. Characteristics associated with opioids only, opioids plus 1, and opioids plus ‡2 additional CNS-active medications were determined using multinomial logistic regression. Outcome measures during 2017 included injurious falls/fractures and ‡3 emergency room (ER) visits. Among eligible insureds (N = 209,947), 57% used opioids only, 28% used opioids plus 1 additional CNS medication, and 15% used ‡2 additional medications. About 60% of opioids and other concurrent CNS medications were prescribed by the same provider, generally a primary care provider. Benzodiazepines and gabapentinoids were most often used concurrently with opioids. Health status, insomnia, anxiety, depression, and low back pain had the strongest associations with concurrent medication use. Overall, concurrent use with ‡2 CNS medications increased the likelihood of injurious falls/fractures or ‡3 ER visits in this population by about 18% and 21%, respectively. Both patients and providers may benefit from an awareness of adverse outcomes associated with concurrent opioid and other CNS-active medication use.

show abstract

Section: Discussionmentioning

confidence: 99%

Concurrent Use of Opioids with Other Central Nervous System-Active Medications Among Older Adults

Wang

Slindee

Ruiz

et al. 2020

Population Health Management

View full text Add to dashboard Cite

show abstract

“…In part to guide this expansion of evidence-based CIH, VHA leaders sought current information on veterans' interest in and use of various CIH approaches, both inside and outside the VHA system because existing surveys of veterans' use of CIH approaches use very small or old samples. 24,25 Veterans represent 7% of the population and are similar to the Medicaid population in that they tend to have less income and education, are predominately male, and are more disabled than the general population. 26 Veterans have high need for management of chronic pain and symptoms of anxiety or depression, [27][28][29] conditions for which some types of CIH might be effective.…”

Section: Introductionmentioning

confidence: 99%

Complementary and Integrated Health Approaches: What Do Veterans Use and Want

2019

View full text Add to dashboard Cite

OBJECTIVES: Non-pharmacological treatment options for common conditions such as chronic pain, anxiety, and depression are being given increased consideration in healthcare, especially given the recent emphasis to address the opioid crisis. One set of non-pharmacological treatment options are evidence-based complementary and integrative health (CIH) approaches, such as yoga, acupuncture, and meditation. The Veterans Health Administration (VHA), the nation's largest healthcare system, has been at the forefront of implementing CIH approaches, given their patients' high prevalence of pain, anxiety, and depression. We aimed to conduct the first national survey of veterans' interest in and use of CIH approaches. METHODS: Using a large national convenience sample of veterans who regularly use the VHA, we conducted the first national survey of veterans' interest in, frequency of and reasons for use of, and satisfaction with 26 CIH approaches (n = 3346, 37% response rate) in July 2017. RESULTS: In the past year, 52% used any CIH approach, with 44% using massage therapy, 37% using chiropractic, 34% using mindfulness, 24% using other meditation, and 25% using yoga. For nine CIH approaches, pain and stress reduction/relaxation were the two most frequent reasons veterans gave for using them. Overall, 84% said they were interested in trying/learning more about at least one CIH approach, with about half being interested in six individual CIH approaches (e.g., massage therapy, chiropractic, acupuncture, acupressure, reflexology, and progressive relaxation). Veterans appeared to be much more likely to use each CIH approach outside the VHA vs. within the VHA. CONCLUSIONS: Veterans report relatively high past-year use of CIH approaches and many more report interest in CIH approaches. To address this gap between patients' level of interest in and use of CIH approaches, primary care providers might want to discuss evidence-based CIH options to their patients for relevant health conditions, given most CIH approaches are safe.

show abstract

“…The level of general anxiety symptoms was found to be consistently positively related with the amount of pain medication use in people experiencing pain, based on univariate analyses (4 analyses reporting a positive association [55,75,108,118] and 1 reporting no association [55]-80% agreement for a relationship), whereas it appeared to be unrelated with the number of consultations with healthcare providers (univariate: 1 analysis reporting a positive association [103], 2 a negative [125] and 5 no association [64,98,103,108]-13%; multivariate: 1 analysis reporting a positive association [103], 1 a negative [125] and 5 no association-14%) and the amount of emergency HCU (univariate: 1 analysis reporting a positive association [110] and 3 no association [85,125]-25%).…”

Section: Associations Between Cef and Amount Of Hcu In People Experiementioning

confidence: 96%

“…Additionally, inconsistent results were found in univariate analyses for a potential association between self-efficacy beliefs and the amount of healthcare consultations (3 reporting a negative association [55,126] and 5 no association [64,98]-38%). Based on multivariate analyses, no evidence for a relationship between the latter was found (1 reporting a negative association [67] and 4 no association [64,126,129]-20%).…”

Section: Associations Between Cef and Amount Of Hcu In People Experiementioning

confidence: 97%

“…Kapoor (2014) [61] 1 1 1 NA 1 1 1 NA 1 1 1 NA NA NA 1 NA 1 NA 1 0 NA NA NA NA 1 0 0 12/16 Kratz (2018) [62] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 12/16 Lee (2008) [63] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 1 14/16 Lozier (2018) [64] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 13/16 Macfarlane (1999) [65] 1 1 NA 1 1 1 NA 0 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 1 0 13/16 Macfarlane (2003) [66] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 13/16 Mann (2017) [67] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 13/16 Mannion (2013) [68] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 12/16 McCracken (1997) [69] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 0 NA 1 NA 1 1 NA NA NA NA 1 0 0 12 /16 McCracken (2007) [70] 1 1 1 NA 1 1 1 NA 0 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 12/16 Mourad (2016) [72] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 1 0 14/16 Mourad (2018) [71] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 0 1 0 13/16 Ndao-Brumblay (2010) [73] 1 1 1 NA 1 1 1 NA 0 1 0 NA NA NA 1 NA 1 NA 0 0 NA NA NA NA 1 0 0 10/16 Newman (2018) [74] 1 1 1 NA 1 1 1 NA 1 0 0 NA NA NA 1 NA 1 NA 1 0 NA NA NA NA 1 0 0 11/16 Nielsen (2015) [75] 1 1 1 NA 1 1 1 NA 0 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 12/16 Pierce (2019) [76] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 0 NA NA NA NA 1 0 0 12/16 Rosenberg (2008) [77] 1 1 1 NA 1 1 1 NA 1 1 0 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 13/16 Shmagel (2016) [78] 1 0 1 NA 1 1 1 NA 1 1 1 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 13/16 Talley (1998) [79] 1 1 1 NA 1 1 1 NA 1 1 1 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 0 0 14/16 Thorstensson (2009) [80] 1 1 1 NA 1 1 1 NA 0 1 1 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 1 1 0 14/16 Torrance (2013) [81] 1 1 1 NA 1 1 1 NA 1 1 1 NA NA NA 1 NA 1 NA 1 1 NA NA NA NA 0 0 0 13/16 Tr...…”

Section: Appendix Cmentioning

confidence: 99%

See 1 more Smart Citation

The Relationship between Cognitive and Emotional Factors and Healthcare and Medication Use in People Experiencing Pain: A Systematic Review

Huysmans

Leemans

Beckwée

et al. 2020

JCM

View full text Add to dashboard Cite

Pain conditions are among the leading causes of global disability, impacting on global healthcare utilization (HCU). Health seeking behavior might be influenced by cognitive and emotional factors (CEF), which can be tackled by specific therapies. The purpose of this study was to systematically review the evidence concerning associations between CEF and HCU in people experiencing pain. Three databases were consulted: PubMed, Web of Science and EconLit. Risk of bias was assessed using the Downs and Black Checklist (modified). A total of 90 publications (total sample n = 59,719) was included after double-blind screening. In people experiencing pain, positive associations between general anxiety symptoms, depressive symptoms and catastrophizing and pain medication use were found. Additionally, there appears to be a relationship between general anxiety and depressive symptoms and opioid use. Symptom-related anxiety and psychological distress were found to be positively related with consulting behavior. Last, a positive association between use of complementary and alternative medicine and level of perceived symptom control was confirmed in people with pain. For other relationships no evidence or inconsistent findings were found, or they were insufficiently studied to draw firm conclusions, indicating that more research on this topic is needed.

show abstract

Correlates of Use and Perceived Effectiveness of Non-pharmacologic Strategies for Chronic Pain Among Patients Prescribed Long-term Opioid Therapy

Cited by 15 publications

References 67 publications

Concurrent Use of Opioids with Other Central Nervous System-Active Medications Among Older Adults

Concurrent Use of Opioids with Other Central Nervous System-Active Medications Among Older Adults

Complementary and Integrated Health Approaches: What Do Veterans Use and Want

The Relationship between Cognitive and Emotional Factors and Healthcare and Medication Use in People Experiencing Pain: A Systematic Review

Contact Info

Product

Resources

About