Cognitive function during opioid tapering in patients with chronic pain: A prospective cohort study
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Cognitive function during opioid tapering in patients with chronic pain : A prospective cohort study. / Laigaard, Jens; Bache, Nina; Stottmeier, Stefan; Mathiesen, Ole; Estrup, Stine.
In: Journal of Pain Research, Vol. 13, 2020, p. 3385-3394.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Cognitive function during opioid tapering in patients with chronic pain
T2 - A prospective cohort study
AU - Laigaard, Jens
AU - Bache, Nina
AU - Stottmeier, Stefan
AU - Mathiesen, Ole
AU - Estrup, Stine
PY - 2020
Y1 - 2020
N2 - Purpose: Evidence for efficacy and safety lacks for long-term opioid therapy in patients with chronic non-cancer pain and adverse effects, including affection of cognitive function and quality of life, is of concern. We aimed to investigate cognitive function and health-related quality of life in patients with chronic non-cancer pain during opioid reduction. Patients and Methods: At two multidisciplinary pain centers, all patients with planned opioid reduction were screened for eligibility. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Trail Making Test A and B. Health-related quality of life was assessed using Short Form-36 (SF36) and Hospital Anxiety and Depression Scale (HADS). Results: We included 51 participants and 40 participants attended follow-up of median 254 (IQR 106–357) days. Baseline RBANS score was 82 (IQR 65–93) with reference population norm value of 100 (SD±15). Daily opioid consumption was reduced from median 80 (IQR 45–161) oral morphine milligram equivalents to 19 (IQR 0–60) mg. RBANS score estimate increased by 6.2 (95% CI 3.1–9.3, p=0.0004) points after tapering. No differences were observed for Trail Making Test times, HADS or SF36 scores. Conclusion: Generally, cognitive function showed minor improvement after opioid tapering with stationary health-related quality of life, depression and anxiety scores. The clinical significance is unclear, as no minimal clinically important difference in RBANS score is available.
AB - Purpose: Evidence for efficacy and safety lacks for long-term opioid therapy in patients with chronic non-cancer pain and adverse effects, including affection of cognitive function and quality of life, is of concern. We aimed to investigate cognitive function and health-related quality of life in patients with chronic non-cancer pain during opioid reduction. Patients and Methods: At two multidisciplinary pain centers, all patients with planned opioid reduction were screened for eligibility. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Trail Making Test A and B. Health-related quality of life was assessed using Short Form-36 (SF36) and Hospital Anxiety and Depression Scale (HADS). Results: We included 51 participants and 40 participants attended follow-up of median 254 (IQR 106–357) days. Baseline RBANS score was 82 (IQR 65–93) with reference population norm value of 100 (SD±15). Daily opioid consumption was reduced from median 80 (IQR 45–161) oral morphine milligram equivalents to 19 (IQR 0–60) mg. RBANS score estimate increased by 6.2 (95% CI 3.1–9.3, p=0.0004) points after tapering. No differences were observed for Trail Making Test times, HADS or SF36 scores. Conclusion: Generally, cognitive function showed minor improvement after opioid tapering with stationary health-related quality of life, depression and anxiety scores. The clinical significance is unclear, as no minimal clinically important difference in RBANS score is available.
KW - Chronic non-cancer pain
KW - Chronic non-malignant pain
KW - Cognitive dysfunction
KW - Cognitive impairment
KW - Memory
KW - Multidisciplinary pain center
U2 - 10.2147/JPR.S273025
DO - 10.2147/JPR.S273025
M3 - Journal article
C2 - 33363405
AN - SCOPUS:85097807363
VL - 13
SP - 3385
EP - 3394
JO - Journal of Pain Research
JF - Journal of Pain Research
SN - 1178-7090
ER -
ID: 255111870