ArticleBMC health services research2005
A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity.
Article in BMC health services research, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 4 of them syntheses that pooled it.
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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.
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.
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Who cites it
37 citing papers in PubMed, 4 syntheses or guidelines pooled it, 132 citations in OpenAlex.
- Effectiveness of Models Used to Deliver Multimodal Care for Chronic Musculoskeletal Pain: a Rapid Evidence Review.Journal of general internal medicine · 2018Pooled it
- [Long-term opioid therapy in chronic noncancer pain. A systematic review and meta-analysis of efficacy, tolerability and safety in open-label extension trials with study duration of at least 26 weeks].Schmerz (Berlin, Germany) · 2015Pooled it
- Canadian guideline for safe and effective use of opioids for chronic noncancer pain: clinical summary for family physicians. Part 2: special populations.Canadian family physician Medecin de famille canadien · 2011Guideline
- Pooled it
- Assessment of Alcohol-Induced Dose Dumping with a Hydrocodone Bitartrate Extended-Release Tablet Formulated with CIMA(®) Abuse Deterrence Technology.Clinical drug investigation · 2015Trial
- Association between substance use disorder status and pain-related function following 12 months of treatment in primary care patients with musculoskeletal pain.The journal of pain · 2011Trial
- Characterising pharmacists' interventions in chronic non-cancer pain care: a scoping review.International journal of clinical pharmacy · 2024Article
- Patient contracts for chronic medical conditions: Scoping review.Canadian family physician Medecin de famille canadien · 2022Article
- Are injured workers with higher rehabilitation service utilization less likely to be persistent opioid users? A cross-sectional study.BMC health services research · 2019Article
- Prescription Medication Use Among Community-Based U.S. Adults With Chronic Low Back Pain: A Cross-Sectional Population Based Study.The journal of pain · 2018Article
- A systematic review of strategies to improve appropriate use of opioids and to reduce opioid use disorder and deaths from prescription opioids.Canadian journal of pain = Revue canadienne de la douleur · 2018Review
- Article
- Defining Team Effort Involved in Patient Care from the Primary Care Physician's Perspective.Journal of general internal medicine · 2017Article
- Nonmedical Prescription Opioid Use and DSM-5 Nonmedical Prescription Opioid Use Disorder in the United States.The Journal of clinical psychiatry · 2016Article
- The Economic Impact of Opioid Use in the Management of Chronic Nonmalignant Pain.Journal of managed care & specialty pharmacy · 2015Review
- Denial of urinalysis-confirmed opioid use in prescription opioid dependence.Journal of substance abuse treatment · 2015Article
- Review
- Co-occurring depression and pain in multiple sclerosis.Physical medicine and rehabilitation clinics of North America · 2013Review
- Days with pain and substance use disorders: is there an association?The Clinical journal of pain · 2013Article
- Attitudes of community pharmacists to antibiotic dispensing and microbial resistance: a qualitative study in Portugal.International journal of clinical pharmacy · 2013Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic non-cancer pain is a common problem that is often accompanied by psychiatric comorbidity and disability. The effectiveness of a multi-disciplinary pain management program was tested in a 3 month before and after trial.
methodsProviders in an academic general medicine clinic referred patients with chronic non-cancer pain for participation in a program that combined the skills of internists, clinical pharmacists, and a psychiatrist. Patients were either receiving opioids or being considered for opioid therapy. The intervention consisted of structured clinical assessments, monthly follow-up, pain contracts, medication titration, and psychiatric consultation. Pain, mood, and function were assessed at baseline and 3 months using the Brief Pain Inventory (BPI), the Center for Epidemiological Studies-Depression Scale scale (CESD) and the Pain Disability Index (PDI). Patients were monitored for substance misuse.
resultsEighty-five patients were enrolled. Mean age was 51 years, 60% were male, 78% were Caucasian, and 93% were receiving opioids. Baseline average pain was 6.5 on an 11 point scale. The average CESD score was 24.0, and the mean PDI score was 47.0. Sixty-three patients (73%) completed 3 month follow-up. Fifteen withdrew from the program after identification of substance misuse. Among those completing 3 month follow-up, the average pain score improved to 5.5 (p = 0.003). The mean PDI score improved to 39.3 (p < 0.001). Mean CESD score was reduced to 18.0 (p < 0.001), and the proportion of depressed patients fell from 79% to 54% (p = 0.003). Substance misuse was identified in 27 patients (32%).
conclusionsA primary care disease management program improved pain, depression, and disability scores over three months in a cohort of opioid-treated patients with chronic non-cancer pain. Substance misuse and depression were common, and many patients who had substance misuse identified left the program when they were no longer prescribed opioids. Effective care of patients with chronic pain should include rigorous assessment and treatment of these comorbid disorders and intensive efforts to insure follow up.
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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.