Evidence map›Paper›PMID 11348910›Full record

Trial reportBMJ (Clinical research ed.)2001

Randomised crossover trial of transdermal fentanyl and sustained release oral morphine for treating chronic non-cancer pain.

L Allan, H Hays, N H Jensen, B L de Waroux, M Bolt, R Donald, E Kalso

Registry-linked trialOpen access · bronzeAbstract readClinical TrialComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03834363 (Morphine or Fentanyl for Refractory Dyspnea in COPD), which is not on this map. Cited by 80 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 4 pooled it
20.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03834363 phase4completednot on this mapstarted 2019, after this paper: background citation

Morphine or Fentanyl for Refractory Dyspnea in COPD

TypeinterventionalSponsorHuib A.M. KerstjensRan2019 to 2024Enrolled59ConditionsCOPDArmsFentanyl, Morphine Retard, Placebo patch, Placebo oral capsule
3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 4 syntheses or guidelines pooled it, 301 citations in OpenAlex.

  1. Guideline
  2. Fentanyl for neuropathic pain in adults.The Cochrane database of systematic reviews · 2016
    Pooled it
  3. Pooled it
  4. [Strong opioids and constipation].Schmerz (Berlin, Germany) · 2005
    Pooled it
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Article
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  18. Review
  19. Review
  20. Article

20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 7 institutions in 7 countries.

L AllanChronic Pain Services, Northwick Park and St Mark's NHS Trust, Harrow, Middlesex HA1 3UJ.
H Hays
N H Jensen
B L de Waroux
M Bolt
R Donald
E Kalso
City of Cape Town · ZACliniques Universitaires Saint-Luc · BEHelsinki University Hospital · FIHerlev Hospital · DKRijnstate Hospital · NLSt Mark's Hospital · GBUniversity of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare patients' preference for transdermal fentanyl or sustained release oral morphine, their level of pain control, and their quality of life after treatment.

designRandomised, multicentre, international, open label, crossover trial.

setting35 centres in Belgium, Canada, Denmark, Finland, the United Kingdom, the Netherlands, and South Africa.

participants256 patients (aged 26-82 years) with chronic non-cancer pain who had been treated with opioids.

main outcome measuresPatients' preference for transdermal fentanyl or sustained release oral morphine, pain control, quality of life, and safety assessments.

resultsOf 212 patients, 138 (65%) preferred transdermal fentanyl, whereas 59 (28%) preferred sustained release oral morphine and 15 (7%) expressed no preference. Better pain relief was the main reason for preference for fentanyl given by 35% of patients. More patients considered pain control as being "good" or "very good" with fentanyl than with morphine (35% v 23%, P=0.002). These results were reflected in both patients' and investigators' opinions on the global efficacy of transdermal fentanyl. Patients receiving fentanyl had on average higher quality of life scores than those receiving morphine. The incidence of adverse events was similar in both treatment groups; however, more patients experienced constipation with morphine than with fentanyl (48% v 29%, P<0.001). Overall, 41% of patients experienced mild or moderate cutaneous problems associated with wearing the transdermal fentanyl patch, and more patients withdrew because of adverse events during treatment with fentanyl than with morphine (10% v 5%). However, within the subgroup of patients naive to both fentanyl and morphine, similar numbers of patients withdrew owing to adverse effects (11% v 10%, respectively).

conclusionTransdermal fentanyl was preferred to sustained release oral morphine by patients with chronic non-cancer pain previously treated with opioids. The main reason for preference was better pain relief, achieved with less constipation and an enhanced quality of life.

Indexed as

Administration, CutaneousAdultAgedAged, 80 and overAnalgesics, OpioidChronic DiseaseCross-Over StudiesDelayed-Action PreparationsFemaleFentanylHumansMaleMiddle AgedMorphinePainPatient SatisfactionAnalgesics, OpioidDelayed-Action PreparationsFentanylMorphine

Identifiers

PMID11348910
PMCPMC31593
OpenAlexW2117950925

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.