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Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study

PURPOSE: Evidence for efficacy and safety lacks for long-term opioid therapy in patients with chronic non-cancer pain and adverse effects, including affection of cognitive function and quality of life, is of concern. We aimed to investigate cognitive function and health-related quality of life in pa...

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Autores principales: Laigaard, Jens, Bache, Nina, Stottmeier, Stefan, Mathiesen, Ole, Estrup, Stine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7754260/
https://www.ncbi.nlm.nih.gov/pubmed/33363405
http://dx.doi.org/10.2147/JPR.S273025
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author Laigaard, Jens
Bache, Nina
Stottmeier, Stefan
Mathiesen, Ole
Estrup, Stine
author_facet Laigaard, Jens
Bache, Nina
Stottmeier, Stefan
Mathiesen, Ole
Estrup, Stine
author_sort Laigaard, Jens
collection PubMed
description PURPOSE: Evidence for efficacy and safety lacks for long-term opioid therapy in patients with chronic non-cancer pain and adverse effects, including affection of cognitive function and quality of life, is of concern. We aimed to investigate cognitive function and health-related quality of life in patients with chronic non-cancer pain during opioid reduction. PATIENTS AND METHODS: At two multidisciplinary pain centers, all patients with planned opioid reduction were screened for eligibility. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Trail Making Test A and B. Health-related quality of life was assessed using Short Form-36 (SF36) and Hospital Anxiety and Depression Scale (HADS). RESULTS: We included 51 participants and 40 participants attended follow-up of median 254 (IQR 106–357) days. Baseline RBANS score was 82 (IQR 65–93) with reference population norm value of 100 (SD±15). Daily opioid consumption was reduced from median 80 (IQR 45–161) oral morphine milligram equivalents to 19 (IQR 0–60) mg. RBANS score estimate increased by 6.2 (95% CI 3.1–9.3, p=0.0004) points after tapering. No differences were observed for Trail Making Test times, HADS or SF36 scores. CONCLUSION: Generally, cognitive function showed minor improvement after opioid tapering with stationary health-related quality of life, depression and anxiety scores. The clinical significance is unclear, as no minimal clinically important difference in RBANS score is available.
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spelling pubmed-77542602020-12-23 Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study Laigaard, Jens Bache, Nina Stottmeier, Stefan Mathiesen, Ole Estrup, Stine J Pain Res Original Research PURPOSE: Evidence for efficacy and safety lacks for long-term opioid therapy in patients with chronic non-cancer pain and adverse effects, including affection of cognitive function and quality of life, is of concern. We aimed to investigate cognitive function and health-related quality of life in patients with chronic non-cancer pain during opioid reduction. PATIENTS AND METHODS: At two multidisciplinary pain centers, all patients with planned opioid reduction were screened for eligibility. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Trail Making Test A and B. Health-related quality of life was assessed using Short Form-36 (SF36) and Hospital Anxiety and Depression Scale (HADS). RESULTS: We included 51 participants and 40 participants attended follow-up of median 254 (IQR 106–357) days. Baseline RBANS score was 82 (IQR 65–93) with reference population norm value of 100 (SD±15). Daily opioid consumption was reduced from median 80 (IQR 45–161) oral morphine milligram equivalents to 19 (IQR 0–60) mg. RBANS score estimate increased by 6.2 (95% CI 3.1–9.3, p=0.0004) points after tapering. No differences were observed for Trail Making Test times, HADS or SF36 scores. CONCLUSION: Generally, cognitive function showed minor improvement after opioid tapering with stationary health-related quality of life, depression and anxiety scores. The clinical significance is unclear, as no minimal clinically important difference in RBANS score is available. Dove 2020-12-14 /pmc/articles/PMC7754260/ /pubmed/33363405 http://dx.doi.org/10.2147/JPR.S273025 Text en © 2020 Laigaard et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Laigaard, Jens
Bache, Nina
Stottmeier, Stefan
Mathiesen, Ole
Estrup, Stine
Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study
title Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study
title_full Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study
title_fullStr Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study
title_full_unstemmed Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study
title_short Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study
title_sort cognitive function during opioid tapering in patients with chronic pain: a prospective cohort study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7754260/
https://www.ncbi.nlm.nih.gov/pubmed/33363405
http://dx.doi.org/10.2147/JPR.S273025
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