title: Physical Functioning and Opioid use in Patients with Neuropathic Pain.
abstract: OBJECTIVE
  To evaluate the association between opioid dosage and ongoing therapy with physical function and disability in patients with neuropathic pain (NeP).
  
  
  METHODS
  Secondary analysis of a prospective cohort.
  
  
  METHODS
  Multicenter clinical NeP registry.
  
  
  METHODS
  Seven hundred eighty-nine patients treated for various NeP diagnoses.
  
  
  METHODS
  The following measures were included: dependent variables. 12-month self-reported physical function (pain disability index [PDI] and medical outcomes study short form-12 physical function [PCSS-12]); independent variables: baseline opioid dose (none, ≤200 mg and >200 mg of morphine equivalent), ongoing opioid use; potential confounding variables: age, sex, baseline pain intensity, and psychological distress (profile of mood states). Analysis of covariance models was created to examine the relationship between opioid therapy and both physical functioning outcomes with adjustment for confounding.
  
  
  RESULTS
  Complete data was available for 535 patients (68%). Compared with the lower and high dose opioid groups, NeP patients not taking opioids had statistically lower disability and higher physical functioning scores, after adjusting for disease severity. Compared with patients prescribed opioid therapy on an ongoing basis, NeP patients who were not prescribed had statistically lower disability and higher physical functioning scores, after adjusting for disease severity. Improvements in disability and physical functioning scores from baseline and 12-months in all groups were modest and may not be clinically significant.
  
  
  CONCLUSIONS
  Physical functioning and disability did not improve in patients with NeP who were prescribed opioids compared with those who are not prescribed, even after adjusting for disease severity.
authors: Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
authors: Geoff P
authors: GP
authors: Bostick
authors: Fraser Valley Health Authority, Burnaby, Canada.
authors: Cory
authors: C
authors: Toth
authors: Faculty of Nursing, University of Calgary, Calgary, Canada.
authors: Eloise C J
authors: http://orcid.org/0000-0003-1870-4244
authors: EC
authors: Carr
authors: LW Stitt Statistical Services, London, Ontario.
authors: Larry W
authors: LW
authors: Stitt
authors: Department of Anaesthesia, Faculty of Medicine & Dentistry, Western University, London, Canada.
authors: Patricia
authors: P
authors: Morley-Forster
authors: Department of Anaesthesia, Faculty of Medicine, Dalhousie University, Halifax, Canada.
authors: Alexander J
authors: AJ
authors: Clark
authors: Department of Anaesthesia, Faculty of Medicine, Dalhousie University, Halifax, Canada.|Department of Psychiatry.|Department of Pharmacology, Division of Neurology, Faculty of Medicine, Dalhousie University, Halifax, Canada.
authors: Mary
authors: M
authors: Lynch
authors: Department of Medicine, University of Toronto, Toronto, Canada.
authors: Allan
authors: A
authors: Gordon
authors: Department of Anaesthesiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
authors: Howard
authors: H
authors: Nathan
authors: Department of Anaesthesiology, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
authors: Catherine
authors: C
authors: Smyth
authors: Department of Family Medicine.|Department of Anaesthesia, Faculty of Medicine, McGill University, Montreal, Canada.
authors: Mark A
authors: MA
authors: Ware
authors: Department of Anaesthesia, Faculty of Medicine & Dentistry, Western University, London, Canada.
authors: Dwight E
authors: DE
authors: Moulin
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D006233:Persons with Disabilities / Q000523:psychology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D009437:Neuralgia / Q000188:drug therapy* / Q000503:physiopathology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine
keywords: Neuropathic Pain; Opioid Therapy; Physical Functioning