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October 23, 2016
10/23/2016 1:00:00 PM - 10/23/2016 3:00:00 PM
Room Hall F Foyer-Area C
Do Patients Perceive Opioid Treatment as an Effective Way to Manage Chronic Low Back Pain? A Survey of Opioid Treatment Perception and Satisfaction
Asokumar Buvanendran, M.D., Rae M. Gleason, B.A., Mario Moric, M.S., Sherry J. Robison, M.B.A., Jeffrey S. Kroin, Ph.D.
Rush Medical College, Chicago, Illinois, United States
Disclosures:  A. Buvanendran: None. R.M. Gleason: None. M. Moric: None. S.J. Robison: None. J.S. Kroin: None.
Introduction: Use of prescription opioids has risen considerably in the last decade and so has prescription opioid abuse. Patients with Chronic Low Back Pain (LBP) make up one of the largest groups of patients with pain issues (30-50%),1,2 and many are treated with opioids. The issue has become a national problem and in a Feb 2, 2016 press release, the White House has proposed $1.1 billion for funding prescription opioid abuse mitigation. As mentioned in the press release “More Americans now die every year from drug overdoses than they do in motor vehicle crashes”. With these issues in mind we wanted to evaluate perception about opioid treatments of patients with LBP. We reached out to a patient advocacy group who had conducted a survey asking for people with LBP to answer questions about opinions related to LBP treatments such as their perspectives on opioid therapy. We will utilize this data to better understand patient attitudes about opioid treatments.

Methods: We assessed a January 2016 online survey of over 2000 LBP patients given by our patient advocacy partners, the National Fibromyalgia and Chronic Pain Association (NFMCPA). NFMCPA members were asked, through email and social media, to answer a range of questions on patient demographics and attitudes on LBP treatments, which were provided in an electronic format as an internet webpage. Analysis was conducted by SAS version 9.2 (SAS Inc. Cary, NC). Statistical procedures used were chi-square test, Fishers exact test, and the Mantel-Haenszel chi-square for tests of trends between the strata.

Results: 2,561 questionnaires were recorded and 2,030 individuals consented and indicated having LBP; of these almost half (941) are currently being treated with opioids. The sample was stratified into three categories, those currently on opioid therapy (46%), those not in current opioid therapy but have been in the past (28%) and those who have never been on opioid therapy (26%). 92% were female and the average age was 56 years old. 26% were being managed by a Primary Care Practitioner (PCP) and 24% were managed by Pain Medicine Specialists (PMS). Of those currently on opioids 24% were seen by PCP and 38% by PMS, while for those never on opioids 31% were seen by PCP and 8% by PMS. For those currently or previously taking opioids, opinions on success of treatment was significantly different(P = 0.0001), with current patients recording higher success than do past opioid patients, [figure1] but still the most common answer for the current use patients was to report only “Somewhat Successful” while for the past use patients it was “Not Successful”. In terms of problems and issues for those patients with current or past use opioid treatment, the distribution of problems was similar; both groups reported constipation as the more common problem but there was some difference in the rates reported, for Constipation, “didn’t help with pain”, dependence and not being able to get or fill prescriptions. [figure2]

Conclusion: The results highlight the lack of perceived efficacy of opioid treatment for chronic pain and the large numbers reporting multiple issues with opioid therapy.

References: 1. PLoS One 2013 Jul 2;8(7):e68273; 2. BMJ 2006;332:1430-34
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