title: Cohort protocol paper: the Pain and Opioids In Treatment (POINT) study.
abstract: BACKGROUND
  Internationally, there is concern about the increased prescribing of pharmaceutical opioids for chronic non-cancer pain (CNCP). In part, this is related to limited knowledge about the long-term benefits and outcomes of opioid use for CNCP. There has also been increased injection of some pharmaceutical opioids by people who inject drugs, and for some patients, the development of problematic and/or dependent use. To date, much of the research on the use of pharmaceutical opioids among people with CNCP, have been clinical trials that have excluded patients with complex needs, and have been of limited duration (i.e. fewer than 12 weeks). The Pain and Opioids In Treatment (POINT) study is unique study that aims to: 1) examine patterns of opioid use in a cohort of patients prescribed opioids for CNCP; 2) examine demographic and clinical predictors of adverse events, including opioid abuse or dependence, medication diversion, other drug use, and overdose; and 3) identify factors predicting poor pain relief and other outcomes.
  
  
  METHODS
  The POINT cohort comprises around 1,500 people across Australia prescribed pharmaceutical opioids for CNCP. Participants will be followed-up at four time points over a two year period. POINT will collect information on demographics, physical and medication use history, pain, mental health, drug and alcohol use, non-adherence, medication diversion, sleep, and quality of life. Data linkage will provide information on medications and services from Medicare (Australia's national health care scheme). Data on those who receive opioid substitution therapy, and on mortality, will be linked.
  
  
  CONCLUSIONS
  This study will rigorously examine prescription opioid use among CNCP patients, and examine its relationship to important health outcomes. The extent to which opioids for chronic pain is associated with pain reduction, quality of life, mental and physical health, aberrant medication behavior and substance use disorders will be extensively examined. Improved understanding of the longer-term outcomes of chronic opioid therapy will direct community-based interventions and health policy in Australia and internationally. The results of this study will assist clinicians to better identify those patients who are at risk of adverse outcomes and who therefore require alternative treatment strategies.
authors.affiliation: National Drug and Alcohol Research Centre, UNSW, Sydney, NSW 2052, Australia. g.campbell@unsw.edu.au.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Campbell
authors.forename: Richard
authors.initials: R
authors.lastname: Mattick
authors.forename: Raimondo
authors.initials: R
authors.lastname: Bruno
authors.forename: Briony
authors.initials: B
authors.lastname: Larance
authors.forename: Suzanne
authors.initials: S
authors.lastname: Nielsen
authors.forename: Milton
authors.initials: M
authors.lastname: Cohen
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lintzeris
authors.forename: Fiona
authors.initials: F
authors.lastname: Shand
authors.forename: Wayne D
authors.initials: WD
authors.lastname: Hall
authors.forename: Bianca
authors.initials: B
authors.lastname: Hoban
authors.forename: Chyanne
authors.initials: C
authors.lastname: Kehler
authors.forename: Michael
authors.initials: M
authors.lastname: Farrell
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
mesh_terms: D000293:Adolescent; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D001315:Australia / Q000453:epidemiology; D059350:Chronic Pain / Q000188:drug therapy*; D015331:Cohort Studies; D062787:Drug Overdose / Q000453:epidemiology; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006801:Humans; D009293:Opioid-Related Disorders / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid