Long-term evaluation of opioid treatment in fibromyalgia

Xiaomei Peng, Rebecca L. Robinson, Philip Mease, Kurt Kroenke, David A. Williams, Yi Chen, Douglas Faries, Madelaine Wohlreich, Bill McCarberg, Danette Hann

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Objectives: In a 12-month observational study, we evaluated the effect of opioid use on the outcomes in 1700 adult patients with fibromyalgia.

Methods: Data were evaluated using propensity score matching after patients were divided into cohorts based on their baseline medication use: (1) taking an opioid (concurrent use of tramadol was permitted); (2) taking tramadol (but no opioids); and (3) not taking opioids or tramadol. Changes in outcomes were assessed using the Brief Pain Inventory for severity and pain-related interference (BPI-S, BPI-I), Fibromyalgia Impact Questionnaire (FIQ), Patient Health Questionnaire for depression (PHQ-8), Insomnia Severity Index (ISI), Sheehan Disability Scale (SDS), 7-item Generalized Anxiety Disorder Scale (GAD-7), and economic factors. Time-to-opioid or tramadol discontinuation was analyzed using Kaplan-Meier survival analyses.

Results: Compared with the opioid cohort, the nonopioid cohort demonstrated significantly greater reductions (P<0.05) in BPI-I, FIQ, PHQ-8, SDS, and ISI; the tramadol cohort compared with the opioid group showed greater reductions on FIQ and ISI. Reductions in BPI-S and GAD-7 did not differ significantly among cohorts. Compared with the opioid cohort, patients in the tramadol cohort had fewer outpatient visits to health care providers. Few significant differences were found between the tramadol and nonopioid cohorts across outcomes.

Discussion: Although pain severity was reduced over time in all cohorts, opioid users showed less improvement in pain-related interference with daily living, functioning, depression, and insomnia. Overall, the findings show little support for the long-term use of opioid medications in patients with fibromyalgia given the poorer outcomes across multiple assessment domains associated with this cohort.

Original languageEnglish
Pages (from-to)7-13
Number of pages7
JournalClinical Journal of Pain
Volume31
Issue number1
DOIs
StatePublished - Jan 14 2015

Fingerprint

Fibromyalgia
Opioid Analgesics
Tramadol
Sleep Initiation and Maintenance Disorders
Therapeutics
Pain
Depression
Propensity Score
Kaplan-Meier Estimate
Survival Analysis
Anxiety Disorders
Health Personnel
Observational Studies
Outpatients
Economics
Equipment and Supplies

Keywords

  • fibromyalgia
  • observational
  • opioids
  • outcomes

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology

Cite this

Peng, X., Robinson, R. L., Mease, P., Kroenke, K., Williams, D. A., Chen, Y., ... Hann, D. (2015). Long-term evaluation of opioid treatment in fibromyalgia. Clinical Journal of Pain, 31(1), 7-13. https://doi.org/10.1097/AJP.0000000000000079

Long-term evaluation of opioid treatment in fibromyalgia. / Peng, Xiaomei; Robinson, Rebecca L.; Mease, Philip; Kroenke, Kurt; Williams, David A.; Chen, Yi; Faries, Douglas; Wohlreich, Madelaine; McCarberg, Bill; Hann, Danette.

In: Clinical Journal of Pain, Vol. 31, No. 1, 14.01.2015, p. 7-13.

Research output: Contribution to journalArticle

Peng, X, Robinson, RL, Mease, P, Kroenke, K, Williams, DA, Chen, Y, Faries, D, Wohlreich, M, McCarberg, B & Hann, D 2015, 'Long-term evaluation of opioid treatment in fibromyalgia', Clinical Journal of Pain, vol. 31, no. 1, pp. 7-13. https://doi.org/10.1097/AJP.0000000000000079
Peng, Xiaomei ; Robinson, Rebecca L. ; Mease, Philip ; Kroenke, Kurt ; Williams, David A. ; Chen, Yi ; Faries, Douglas ; Wohlreich, Madelaine ; McCarberg, Bill ; Hann, Danette. / Long-term evaluation of opioid treatment in fibromyalgia. In: Clinical Journal of Pain. 2015 ; Vol. 31, No. 1. pp. 7-13.
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