Health‐Related Quality of Life among Chronic Opioid Users, Nonchronic Opioid Users, and Nonopioid Users with Chronic Noncancer Pain

Hayes, Corey J.; Li, Xiaocong; Li, Chenghui; Shah, Anuj; Kathe, Niranjan; Bhandari, Naleen Raj; Payakachat, Nalin

doi:10.1111/1475-6773.12836

Cited by 15 publications

(17 citation statements)

References 44 publications

(42 reference statements)

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“…In light of the recent opioid epidemic, many studies been conducted to evaluate the efficacy of alternative, less‐addictive approaches to pain control in nononcology settings showing similar effectiveness. Although worsened HRQOL is a theoretical risk after opiate discontinuation, the available data actually support withdrawal . These data support a position of clinical equipoise and justify similar clinical trials in patients with cirrhosis.…”

Section: Discussionmentioning

confidence: 66%

“…We acknowledge that poor HRQOL in these patients may be driven by the indications for opiate or benzodiazepine use and not necessarily a direct effect of these medications in patients with cirrhosis . However, these medications are well recognized to have adverse effects in patients with cirrhosis and can often be substituted for safer therapies without worsening symptoms and other PROs …”

Section: Discussionmentioning

confidence: 98%

“…(37) However, these medications are well recognized to have adverse effects in patients with cirrhosis and can often be substituted for safer therapies without worsening symptoms and other PROs. (10,13)…”

Section: A Conceptual Model Of Quality Of Life In Cirrhosis With Portmentioning

confidence: 99%

“…Psychoactive medications are frequently used, have unique adverse effects in patients with cirrhosis, and can often be substituted for equally effective alternative therapies that do not have the sedating side effects . Indeed, in a nationally representative study of patients with noncancer chronic pain propensity matched for opiate use, opiates were not associated with improved pain or significantly different PROs . Similarly, frailty is also common among patients with cirrhosis, associated with poor PROs, and in some patients may be reversed with nutrition and physical therapy …”

mentioning

confidence: 99%

“…(10)(11)(12) Indeed, in a nationally representative study of patients with noncancer chronic pain propensity matched for opiate use, opiates were not associated with improved pain or significantly different PROs. (13) Similarly, frailty is also common among patients with cirrhosis, associated with poor PROs, and in some patients may be reversed with nutrition and physical therapy. (14)(15)(16)(17)…”

mentioning

confidence: 99%

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Frailty, Psychoactive Medications, and Cognitive Dysfunction Are Associated With Poor Patient‐Reported Outcomes in Cirrhosis

et al. 2019

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Cirrhosis is associated with disabling symptoms and diminished health‐related quality of life (HRQOL). However, for patients with compensated disease, data are limited regarding associations with poor patient‐reported outcomes (PROs). We prospectively enrolled 300 patients with cirrhosis and portal hypertension without a history of hepatic encephalopathy (HE) and reviewed medical and pharmacy records. We characterized determinants of PROs using the 8‐item Short‐Form Health Survey (SF‐8) scale (0‐100) and sleep quality using the Pittsburgh Sleep Quality Index (PSQI; poor sleep >5). Disability and frailty measures were assessed using activities of daily living (ADLs), falls, hand‐grip, and chair‐stands. Cognitive function was measured using weighted‐lures from the Inhibitory Control Test (ICT). The median age of our cohort was 60 (interquartile range [IQR], 52‐66) years, 56.3% were male, and 70% Child class A. All patients had portal hypertension, 76% had varices, and 41% had a history of ascites (predominantly well controlled). The median Model for End‐Stage Liver Disease with Sodium (MELD‐Na) score was 9 (IQR, 7‐13). The overall median SF‐8 was 70 (IQR, 54‐86). Multivariate analysis showed that after adjusting for age, sex, education, and MELD‐Na, performance on chair‐stands (9.28 HRQOL points [95% confidence interval {CI}, 4.76‐13.8] per 10‐stands), ADL dependence (–6.06 [–10.8 to –1.36]), opiate use (–5.01 [–7.84 to –2.19]), benzodiazepine use (–3.50 [–6.58 to –0.42]), and ICT performance (–0.10 [–0.20 to 0.001] per weighted‐lure) were significantly associated with HRQOL. Among patients completing the ICT, poor HRQOL (score <50) was significantly associated with chair‐stands (odds ratio [OR] per 10‐stands, 0.24; 95% CI [0.11‐0.56]) and weighted lures (OR per weighted‐lure, 1.01 [1.00‐1.03]). Poor sleep quality was associated with opiate use (OR, 2.85 [1.11‐7.29]) and lures (OR per‐lure, 1.03 [1.00‐1.05]). Conclusion: Disability, chair‐stand performance, cognitive dysfunction, as well as psychoactive medication use are significantly associated with PROs in patients with clinically stable cirrhosis.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 98%

Section: A Conceptual Model Of Quality Of Life In Cirrhosis With Portmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Frailty, Psychoactive Medications, and Cognitive Dysfunction Are Associated With Poor Patient‐Reported Outcomes in Cirrhosis

et al. 2019

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A Longitudinal Study of the Association of Opioid Use with Change in Pain Interference and Functional Limitations in a Nationally Representative Cohort of Adults with Osteoarthritis in the United States

et al. 2019

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Introduction: Real-world data are sparse on longitudinal associations of opioid use with pain interference with activities (PIA) and daily function with osteoarthritis (OA) in the USA. Methods: Data from the 2010-2015 Medical Expenditure Panel Surveys were analyzed for community-dwelling adults with OA. Opioid use patterns were defined as persistent, intermittent, and no use. Evaluated outcomes were a change in PIA and functional limitations (activities of daily living [ADL], instrumental ADL [IADL], social and work activities, and cognitive function). Multivariable regression analyses explored the association of persistent/ Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11353643.

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Relationships of self-reported opioid and benzodiazepine use with health-related quality of life among adults with spinal cord injury

Krause,

DiPiro,

Dismuke-Greer

et al. 2024

Disability and Health Journal

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Health‐Related Quality of Life among Chronic Opioid Users, Nonchronic Opioid Users, and Nonopioid Users with Chronic Noncancer Pain

Abstract: Clinicians should evaluate opioid use in participants with CNCP as opioid use is not correlated with better HRQoL.

Cited by 15 publications

References 44 publications

Frailty, Psychoactive Medications, and Cognitive Dysfunction Are Associated With Poor Patient‐Reported Outcomes in Cirrhosis

Frailty, Psychoactive Medications, and Cognitive Dysfunction Are Associated With Poor Patient‐Reported Outcomes in Cirrhosis

A Longitudinal Study of the Association of Opioid Use with Change in Pain Interference and Functional Limitations in a Nationally Representative Cohort of Adults with Osteoarthritis in the United States

Relationships of self-reported opioid and benzodiazepine use with health-related quality of life among adults with spinal cord injury

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