Evidence map›Paper›PMID 25404530›Full record

ArticleDeutsches Arzteblatt international2014

Long-term opioid use in non-cancer pain.

Winfried Häuser, Fritjof Bock, Peter Engeser, Thomas Tölle, Anne Willweber-Strumpfe, Frank Petzke

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Deutsches Arzteblatt international, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 6 pooled it
10.6field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 6 syntheses or guidelines pooled it, 99 citations in OpenAlex.

  1. Guideline
  2. Guideline
  3. Pooled it
  4. Opioid Rotation in Cancer Pain Treatment.Deutsches Arzteblatt international · 2018
    Pooled it
  5. Pooled it
  6. Pooled it
  7. An Internet-Based Intervention for Chronic Pain.Deutsches Arzteblatt international · 2017
    Trial
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Article
  15. An exploratory study of factors associated with long-term, high-dose opioid prescription in cancer patients in Japan based on a medical claims database.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
    Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Winfried HäuserDepartment of Internal Medicine 1 and Medical Health Care Center (MVZ) Saarbrücken St. Johann, Saarbrücken, Orthopedic Center am grünen Turm, Grüner-Turm-Straße 4-10, Ravensburg, Primary care practice, Hohenzollernstraße 36, Pforzheim and Department of General Practice and Health Services Research at Heidelberg University, Heidelberg, Department of Neurology, Technische Universität München, Munich, Pain Day Hospital and Outpatient Clinic, University of Goettingen, Göttingen.
Fritjof Bock
Peter Engeser
Thomas Tölle
Anne Willweber-Strumpfe
Frank Petzke
Heidelberg University · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe long-term use of opioid analgesic drugs to treat chronic non-cancer pain (CNCP) is a major component of pain pharmacotherapy. The interpretation of the evidence concerning its efficacy and risks is currently debated.

methodsAn interdisciplinary evidence- and consensus-based S3 guideline was updated on the basis of a systematic literature search (CENTRAL, Medline, and Scopus databases, from October 2008 to October 2013); meta-analyses of randomized controlled trials (≥ 4 weeks); and a consensus procedure, as specified by the AWMF regulations, including 22 medical and psychological societies and 2 patient self-help organizations.

results119 publications were used to update the guideline, and 6 systematic reviews with meta-analyses were performed. A nominal group process was used to formulate recommendations concerning the indications and contraindications for the treatment of CNCP with opioid analgesics and the manner in which such treatments should be carried out. Opioid analgesics are an option for the short-term treatment (4-12 weeks) of chronic pain due to osteoarthritis (pain intensity, standardized mean difference [SMD]: -0.22 and -0.26), diabetic polyneuropathy (SMD -0.74), post-herpetic neuralgia (SMD -0.58), and chronic low back pain (SMD: -0.29 and -0.74). Long-term opioid treatment (≥ 26 weeks) for these diseases benefits only about 25% of patients. For other conditions, either short- or long-term treatment with opioid analgesics should be considered an individual therapeutic trial. Opioid treatment for pain is contraindicated by primary headaches and by any functional or mental disorder of which pain is a leading manifestation.

conclusionTo minimize the risks of opioid analgesic treatment, physicians must be aware of its contraindications and must regularly reassess its efficacy and side effects. Pharmacotherapy should be combined with other types of treatment.

Indexed as

Practice Guidelines as TopicAnalgesics, OpioidChronic PainDrug Administration ScheduleEvidence-Based MedicineGermanyHeadacheHumansMental DisordersNeoplasmsPain ManagementAnalgesics, Opioid

Identifiers

PMID25404530
PMCPMC4238316
OpenAlexW2203090015

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.