Improved Treatment for Patients With Long-term Opioid Therapy for Non-cancer Pain in Primary Care (Opi-Prim)

What this Trial Is About

Researchers are evaluating a new person-centred and team-based approach to reduce inappropriate long-term opioid treatment (LTOT) and improve pain management in patients with chronic non-cancer pain in primary care. The study aims to compare this approach to usual care, focusing on its effects on pain interference over a 12-month period. This research responds to concerns about the weak evidence for opioid use in chronic non-cancer pain and seeks to optimize treatment through a multi-professional and individualized approach. The intervention consists of three phases: Phase 1 includes investigation and assessment during weeks 1 to 3, involving medication review by a pharmacist, pain analysis by a general practitioner, and visits to a physiotherapist, psychologist, and care manager. Phase 2, during weeks 3 to 4, involves a team consultation including the patient to create an individualized rehabilitation plan. Phase 3, from weeks 4 to 24, consists of implementing this plan with frequent follow-up contacts by phone with the care manager and a second team consultation at the halfway point. Participants in control centers will receive usual care without pharmacist involvement but may access centralized medication reviews. Participants will be involved for 52 weeks and will undergo assessments of pain interference, pain intensity, symptoms of depression and anxiety, patient satisfaction, quality of life, opioid use, and withdrawal symptoms at 3, 6, and 12 months. Follow-up includes frequent phone contacts and team consultations. Researchers will measure changes in pain interference as the primary outcome after 6 months, alongside several secondary outcomes. This thorough monitoring aims to understand how the team-based approach affects pain and opioid use compared to usual care.

Improved Treatment for Patients With Long-term Opioid Therapy for Non-cancer Pain in Primary Care