Opioid therapy for chronic non-cancer pain: guidelines for Hong Kong

Cheung, CW; Chan, Timmy Cw; Chen, PP; Chu, MC; Chui, William; Ho, PT; Lam, Flori; Law, Sheung Wai; Lee, Josephine Ly; Wong, Shawn; Wong, Vincent Kc

doi:10.12809/hkmj164920

Cited by 10 publications

(10 citation statements)

References 45 publications

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“…Hence, management of complex CNCP requires a multidisciplinary team for optimal patient outcome [23]. Opioids may also be considered in carefully selected patients when optimized treatment options are ineffective, and when benefits outweigh harm [12,14,16,17].…”

Section: Discussionmentioning

confidence: 99%

“…The impact of chronic pain on the biopsychosocial effects of patients is well-established [41][42][43][44]. Therefore, physicians are encouraged to adopt the biopsychosocial model to assess and treat CNCP [16,45,46]. This survey presents some limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Because CNCP has a multifactorial etiology [13], a multidimensional approach that integrates both pharmacological and non-pharmacological therapeutic strategies is usually required for effective management of pain [14,15]. International guidelines [12,14,16,17] recommend initiating opioids only when non-opioid and nonpharmacologic therapies are ineffective at managing chronic pain and when benefits of opioids outweigh harm. A shortterm trial of opioids at the lowest effective dose may be initiated for selected patients (i.e., no current/past substance use disorder and no active psychiatric disorders) who continue to experience pain despite optimized non-opioid therapy.…”

Section: Introductionmentioning

confidence: 99%

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Inadequate Management of Chronic Non-cancer Pain and Treatment-Related Adverse Events in Asia: Perspectives from Patients from 10 Countries/Regions

Cheung

Choo

Kim

et al. 2019

SN Compr. Clin. Med.

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Findings from the published ACHEON study revealed inadequate pain relief for chronic non-cancer pain (CNCP) across 10 Asian countries/regions. Hence, we performed additional analyses on the survey data to understand management practices for relieving CNCP and treatment-related adverse events (AEs). Descriptive statistics were used to summarize patients' profile, prescribed treatments, and associated AEs. Two-sample t test was used to compare pain levels between treatment groups. Univariate analyses were conducted to identify factors associated with pain intensity, presence of any common AEs, perceived treatment adequacy, patient-physician interaction, and employment status. Of 1305 patients surveyed, the median duration of CNCP was 24 (interquartile range, 39) months. The majority of patients (89.3%) reported having moderate (44.4%) or severe pain (44.9%). Most patients (80.1%) were prescribed non-opioids, while 16.2% of patients were untreated for pain. Although over half of the treated patients (53.8%) experienced AEs while receiving pain treatment, two-fifths were prescribed medications to manage these AEs. High pain levels, presence of AEs, and employment status influenced patients' perception of treatment adequacy. Patients were more willing to inform their physicians when pain levels were higher and when they perceived sufficient time with physicians. These findings revealed inadequate treatment of CNCP in patients from the participating countries/regions. CNCP management may be improved through increased physician-patient interaction time and adopting a biopsychosocial model for treatment. A proactive and multidimensional approach is required to manage CNCP and potential treatment-related AEs so as to provide optimal care for patients experiencing CNCP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Inadequate Management of Chronic Non-cancer Pain and Treatment-Related Adverse Events in Asia: Perspectives from Patients from 10 Countries/Regions

Cheung

Choo

Kim

et al. 2019

SN Compr. Clin. Med.

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show abstract

“…Esta situación ha hecho que múltiples sociedades científicas elaboren guías sobre el uso racional de opioides (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Éstas establecen que los pacientes con factores de riesgo de adicción no necesariamente deben ser excluidos de la terapia con opioides si se ha determinado que precisan dicho tratamiento, sino que deben utilizarse después de establecer un plan terapéutico y de monitorización individualizada (15).…”

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Tratamiento con opiodes en dolor crónico no oncológico: Recomendaciones para una prescripción segura

Falcón

Morera

2017

Rev. Soc. Esp. Dolor.

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“…Strong opioids are often prescribed, despite their side-effects and lack of good longterm efficacy. 3 For some of these patients, SCS offers effective pain relief and consequent improved function. The Neuromodulation Appropriateness Consensus Committee (NACC) recommends use of neuromodulation techniques before long-term opioids for neuropathic pain.…”

Section: Introductionmentioning

confidence: 99%

Spinal cord stimulation for chronic non-cancer pain: a review of current evidence and practice

2017

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Opioid therapy for chronic non-cancer pain: guidelines for Hong Kong

Cited by 10 publications

References 45 publications

Inadequate Management of Chronic Non-cancer Pain and Treatment-Related Adverse Events in Asia: Perspectives from Patients from 10 Countries/Regions

Inadequate Management of Chronic Non-cancer Pain and Treatment-Related Adverse Events in Asia: Perspectives from Patients from 10 Countries/Regions

Tratamiento con opiodes en dolor crónico no oncológico: Recomendaciones para una prescripción segura

Spinal cord stimulation for chronic non-cancer pain: a review of current evidence and practice

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