Chronic opioid therapy in patients with chronic noncancer pain in Taiwan.
OBJECTIVE
Our aim was to analyze the physiopsychosocial variables in patients with long-term opioid therapy for chronic noncancer pain (CNCP) in Taiwan.


METHODS
Patients registered in the database of the National Bureau of Controlled Drugs (NBCD), Taiwan, were interviewed and completed questionnaires on pain assessment and interference in quality of life, using the Taiwanese version of the Brief Pain Inventory, and questionnaires on depressive status, using the Chinese version of the Beck Depression Inventory-II; in addition, they completed questionnaires on the adverse effects of the opioid therapy and the use of complementary and alternative medicine.


RESULTS
Of 114 patients registered at the NBCD, Taiwan, in August 2001, 61 completed the interviewing procedures and questionnaires. The durations of pain and opioid administration were 93.6 ± 84.3 months (range, 10-480, median 72) and 54.2 ± 57.6 months (range, 6-240, median 30), respectively. Significantly reduced pain intensity (range, 8.8 ± 2.0 to 3.2 ± 2.5) and pain-induced interference with general activity (8.2 ± 2.6 to 3.5 ± 2.5), in addition to improvements in mood, walking ability, normal work, relationships with other people, sleep, and enjoyment of life, indicated remarkably improved quality of life after chronic opioid therapy. The major adverse effects of the opioids were constipation (48%), dry mouth (30%), and nausea and vomiting (21%). Almost half of the patients reported decreases in sexual desire and capability. Up to 60% of the patients received alternative medicine, including acupuncture and herbal drugs. Despite the improved quality of life, 31 of the 61 patients stated that they had moderate or severe depression.


CONCLUSIONS
The long-term use of opioids provided significant improvement of pain relief and quality of life in these patients with CNCP; this therapy is a good solution if other modalities are not effective or useful.
Lin
Tso-Chou
TC
Department of Anesthesiology, Tri-Service General Hospital/National Defense Medical Center, Taipei, Taiwan.
Hsu
Che-Hao
CH
Lu
Chih-Cherng
CC
Tsai
Yu-Chuan
YC
Ho
Shung-Tai
ST
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D000529:Complementary Therapies; D003863:Depression / Q000150:complications / Q000523:psychology; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
D000701:Analgesics, Opioid