Patient outcomes in dose reduction or discontinuation of long-term opioid therapy: a systematic review.
Opioid medication use is associated with an increased risk of adverse drug events, including overdose-related deaths. A previous study demonstrated that patients prescribed higher doses of opioid medications or longer duration of opioid therapy were more likely to continue to use opioid medications over time. Although recent opioid prescribing guidelines recommend reducing doses and limiting duration of therapy, the impact of adherence to these guidelines on patient outcomes remains unknown. This systematic review included 67 studies involving dose reduction or discontinuation of long-term opioid therapy in patients being treated for chronic pain. Researchers conclude that the evidence on the effectiveness of interventions aimed at decreasing long-term opioid therapy and reducing doses on improving patient outcomes such as pain, function, and quality of life is limited. An accompanying editorial comments on the challenges associated with chronic pain management and acknowledges the need for further research in this area.