This study aims to investigate the cognitive function of patients in the opioid reduction programme at the multidisciplinary pain centre at Zealand University Hospital Køge. The patients will be tested before, halfway through, and after the programme.
The number of patients with chronic non-malignant pain is high and constant. An estimated 3-5% of the population use opioids daily. These patients have a lower quality of life and a higher use of healthcare services. This leads to enormous costs, both human and economic. Many patients lose their ability to work, not only because of the pain, but also because of their treatment. For a long period, opioids have been prescribed for chronic pain, even though the evidence is scarce. A rising conscience about opioid use is on the way, and now, there is a tendency to reduce, rather than increase opioids. The reasons are many: Constipation, inability to drive, a sense of drowsiness and no relief of pain, just to name a few. Furthermore, opioids may have decreased effect over time or may even lead to higher levels of pain. Many patients are at first reluctant to start the reduction programme. Mostly because the patients may not be aware of the effects, the drugs are having on them. Many patients value their opioid treatment as positive and necessary, in spite of the many adverse effects. The investigators wanted to test the cognitive function of patients before, during and after opioid reduction. The results can be used to help patients understand the deleterious effects of high opioid usage, and can also be used to motivate the individual patient along the way.
Study Type
OBSERVATIONAL
Enrollment
50
Holbæk Hospital
Holbæk, Denmark
Zealand University Hospital
Køge, Denmark
Cognitive function before opioid reduction
Cognitive function measured with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)
Time frame: At first visit to pain clinic (Day 1)(Individual date, inclusion is possible throughout study period)
Cognitive function at halfway point
Cognitive function measured with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)
Time frame: When opioids are reduced to half the dose (Opioid tapering is an individual process, and thus the time frame is individual, based upon morphine-reduction regimen, approximately 6 months)
Cognitive function at end of reduction
Cognitive function measured with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).
Time frame: When reduction is complete (Opioid tapering is an individual process, and thus the time frame is individual, based upon morphine-reduction regimen, approximately 12 months)
Executive function before opioid reduction
Executive function measured by Trail making test A and B
Time frame: At first visit to pain clinic (Day 1)(Individual date, inclusion is possible throughout study period)
Executive function at halfway point
Executive function measured by Trail making test A and B
Time frame: When opioids are reduced to half the dose (Opioid tapering is an individual process, and thus the time frame is individual, based upon morphine-reduction regimen, approximately 6 months)
Executive function at end of reduction
Executive function measured by Trail making test A and B
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Time frame: When reduction is complete (Opioid tapering is an individual process, and thus the time frame is individual, based upon morphine-reduction regimen, approximately 12 months)
Morphine use before reduction
Morphine equivalents before reduction
Time frame: At first visit to pain clinic (Individual date, inclusion is possible throughout study period)
Morphine use after reduction
Morphine equivalents after reduction
Time frame: At end of reduction (Opioid tapering is an individual process, and thus the time frame is individual, based upon morphine-reduction regimen, approximately 12 months)
Use of other analgesics before reduction
Use of any other analgesic
Time frame: At first visit to pain clinic (Day 1)(Individual date, inclusion is possible throughout study period)
Use of other analgesics at halfway point
Use of any other analgesic
Time frame: When opioids are reduced to half the dose (Opioid tapering is an individual process, and thus the time frame is individual, based upon morphine-reduction regimen, approximately 6 months)
Use of other analgesics after reduction
Use of any other analgesic
Time frame: At end of reduction (Opioid tapering is an individual process, and thus the time frame is individual, based upon morphine-reduction regimen, approximately 12 months)
Quality of life before reduction
Quality of life measured by SF36
Time frame: At first visit to pain clinic (Day 1)(Individual date, inclusion is possible throughout study period)
Quality of life at halfway point
Quality of life measured by SF36
Time frame: When opioids are reduced to half the dose (Opioid tapering is an individual process, and thus the time frame is individual, based upon morphine-reduction regimen, approximately 6 months)
Quality of life at end of reduction
Quality of life measured by SF36
Time frame: At end of reduction (Opioid tapering is an individual process, and thus the time frame is individual, based upon morphine-reduction regimen, approximately 12 months)
Risk of anxiety and depression before reduction
Risk of anxiety and depression measured by Hospital anxiety and depression scale
Time frame: At first visit to pain clinic (Day 1)(Individual date, inclusion is possible throughout study period)
Risk of anxiety and depression at halfway point
Risk of anxiety and depression measured by Hospital anxiety and depression scale
Time frame: When opioids are reduced to half the dose (Opioid tapering is an individual process, and thus the time frame is individual, based upon morphine-reduction regimen, approximately 6 months)
Risk of anxiety and depression at end of reduction
Risk of anxiety and depression measured by Hospital anxiety and depression scale
Time frame: At end of reduction (Opioid tapering is an individual process, and thus the time frame is individual, based upon morphine-reduction regimen, approximately 12 months)