Evidence map›Paper›PMID 36657771›Full record

ArticleBMJ open2023

Feasibility study of a Behavioural Intervention for Opioid Reduction (BIOR) for patients with chronic non-cancer pain in primary care: a protocol.

Helen M Poole, Bernhard Frank, Emma Begley, Aimee Woods, Andreia Ramos-Silva, Mike Merriman, Roisin McCulough, Catharine Montgomery

Open access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 33% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Taking the pain out of pain.British journal of pain · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Helen M PooleSchool of Psychology, Liverpool John Moores University, Liverpool, UK h.m.poole@ljmu.ac.uk.ORCID 0000-0002-6165-3764
Bernhard FrankPain Research Institute, Liverpool, UK.
Emma BegleyAston University, Birmingham, UK.
Aimee WoodsSchool of Psychology, Liverpool John Moores University, Liverpool, UK.
Andreia Ramos-SilvaSchool of Psychology, Liverpool John Moores University, Liverpool, UK.
Mike MerrimanKnowsley Primary Care Trust, Prescot, UK.
Roisin McCuloughKnowsley Primary Care Trust, Prescot, UK.
Catharine MontgomerySchool of Psychology, Liverpool John Moores University, Liverpool, UK.ORCID 0000-0003-2805-5807
Liverpool John Moores University · GBSt Helens and Knowsley Teaching Hospitals NHS Trust · GBAston University · GBPain Relief Foundation · GBUniversity of Liverpool · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAround 30%-50% of adults suffer moderate to severe chronic pain not caused by cancer. Significant numbers are treated with opioids which over time may cease to be effective and produce side effects (eg, nausea, drowsiness and constipation). Stopping taking opioids abruptly can cause unpleasant withdrawal effects. Tapering in small steps is recommended, though some patients might struggle and need support, particularly if they have limited access to pain management alternatives. Awareness of the potential risks as well as benefits of tapering should be explored with patients. METHODS AND ANALYSIS: A randomised controlled pilot feasibility study to investigate the effectiveness and feasibility of reducing high doses of opioids through a tapering protocol, education and support in primary care. Working with NHS Knowsley Place, we will identify patients taking 50 mg or above morphine equivalent dose of opioids per day to be randomly allocated to either the tapering group or tapering with support group. At an initial joint appointment with a pain consultant and General Practitioner (GP) GP tapering will be discussed and negotiated. Both groups will have their opioid reduced by 10% per week. The taper with support group will have access to additional support, including motivational counselling, realistic goal setting and a toolkit of resources to promote self-management. Some patients will successfully reduce their dose each week. For others, this may be more difficult, and the tapering reduction will be adjusted to 10% per fortnight. We assess opioid use, pain and quality of life in both groups at the start and end of the study to determine which intervention works best to support people with chronic pain who wish to stop taking opioids. ETHICS AND DISSEMINATION: The Behavioural Intervention for Opioid Reduction feasibility study has been granted full approval by Liverpool Central Research Ethics Committee on 7 April 2022 (22/NW/0047). The current protocol version is V.1.1, date 6 July 2022. Results will be published in peer-reviewed journals and disseminated to patient stakeholders in a lay summary report available on the project website and in participating GP surgeries. TRIAL REGISTRATION NUMBER: ISRCTN 30201337.

Indexed as

Chronic PainAdultAnalgesics, OpioidFeasibility StudiesHumansMorphinePrimary Health CareQuality of LifeRandomized Controlled Trials as TopicAnalgesics, OpioidMorphinePain managementPAIN MANAGEMENTPRIMARY CARE

Identifiers

PMID36657771
PMCPMC9853248
OpenAlexW4317567942

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.